Operative management of chronic pancreatitis: A review

Abstract Background Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach...

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Veröffentlicht in:The American journal of surgery 2017-08, Vol.214 (2), p.347-357
Hauptverfasser: Tillou, John D., M.D, Tatum, Jacob A., B.S, Jolissaint, Joshua S., M.D, Strand, Daniel S., M.D, Wang, Andrew Y., M.D, Zaydfudim, Victor, M.D., M.P.H, Adams, Reid B., M.D, Brayman, Kenneth L., M.D., PhD
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container_end_page 357
container_issue 2
container_start_page 347
container_title The American journal of surgery
container_volume 214
creator Tillou, John D., M.D
Tatum, Jacob A., B.S
Jolissaint, Joshua S., M.D
Strand, Daniel S., M.D
Wang, Andrew Y., M.D
Zaydfudim, Victor, M.D., M.P.H
Adams, Reid B., M.D
Brayman, Kenneth L., M.D., PhD
description Abstract Background Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. Results There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc.), resection (pancreticoduodenectomy, etc.) and combined drainage/resection procedures (Frey procedure, etc.). Additionally, many centers currently perform total pancreatectomy with islet autotransplantation, in addition to minimally invasive options that are intended to tailor therapy to individual patients. Discussion Operative management of chronic pancreatitis often improves quality of life, and is associated with low rates of morbidity and mortality. The decision as to which procedure is optimal for each patient should be based on a combination of pathologic changes, prior interventions, and individual surgeon and center experience.
doi_str_mv 10.1016/j.amjsurg.2017.03.004
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Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. Results There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc.), resection (pancreticoduodenectomy, etc.) and combined drainage/resection procedures (Frey procedure, etc.). Additionally, many centers currently perform total pancreatectomy with islet autotransplantation, in addition to minimally invasive options that are intended to tailor therapy to individual patients. Discussion Operative management of chronic pancreatitis often improves quality of life, and is associated with low rates of morbidity and mortality. The decision as to which procedure is optimal for each patient should be based on a combination of pathologic changes, prior interventions, and individual surgeon and center experience.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2017.03.004</identifier><identifier>PMID: 28325588</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Alcohol ; Chronic ; Cysts ; Decision Trees ; Drainage ; Endoscopy ; Gangrene ; Humans ; Intervention ; Management ; Morbidity ; Ostomy ; Pain ; Pain - etiology ; Pain - surgery ; Pain Management - methods ; Pancreas ; Pancreatectomy ; Pancreaticojejunostomy ; Pancreatitis ; Pancreatitis, Chronic - complications ; Pancreatitis, Chronic - diagnosis ; Pancreatitis, Chronic - surgery ; Patients ; Quality of life ; Robotics ; Surgery ; Surgical drains ; Therapy ; Transplants &amp; implants</subject><ispartof>The American journal of surgery, 2017-08, Vol.214 (2), p.347-357</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. 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Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. Results There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc.), resection (pancreticoduodenectomy, etc.) and combined drainage/resection procedures (Frey procedure, etc.). Additionally, many centers currently perform total pancreatectomy with islet autotransplantation, in addition to minimally invasive options that are intended to tailor therapy to individual patients. Discussion Operative management of chronic pancreatitis often improves quality of life, and is associated with low rates of morbidity and mortality. 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Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach. Results There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc.), resection (pancreticoduodenectomy, etc.) and combined drainage/resection procedures (Frey procedure, etc.). Additionally, many centers currently perform total pancreatectomy with islet autotransplantation, in addition to minimally invasive options that are intended to tailor therapy to individual patients. Discussion Operative management of chronic pancreatitis often improves quality of life, and is associated with low rates of morbidity and mortality. 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subjects Abdomen
Alcohol
Chronic
Cysts
Decision Trees
Drainage
Endoscopy
Gangrene
Humans
Intervention
Management
Morbidity
Ostomy
Pain
Pain - etiology
Pain - surgery
Pain Management - methods
Pancreas
Pancreatectomy
Pancreaticojejunostomy
Pancreatitis
Pancreatitis, Chronic - complications
Pancreatitis, Chronic - diagnosis
Pancreatitis, Chronic - surgery
Patients
Quality of life
Robotics
Surgery
Surgical drains
Therapy
Transplants & implants
title Operative management of chronic pancreatitis: A review
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