Abstract:
Objective To investigate the application and effect of basin-type internal drainage of the pancreatic duct in the treatment of sub-acute chronic pancreatitis.
Methods Clinical data of 11 patients with sub-acute chronic pancreatitis undergoing basin-type internal drainage of the pancreatic duct in People's Hospital of Hunan Province from December 2016 to June 2018 were retrospectively analyzed. Among them, 10 patients were male and 1 female, aged 13-69 years with a median age of 40 years. The informed consents of all patients were obtained and the local ethical committee approval was received. 9 cases were complicated with pancreatic duct stones, 11 cases complicated with pancreatic pseudocysts and 5 cases complicated with peri-pancreatic abscess. All patients underwent basin-type internal drainage of the pancreatic duct. After the pancreatic duct was incised, the stones, peri-pancreatic pseudocysts or abscesses were cleared, the dilatate pancreatic duct was designed in a basin shape. Roux-en-Y anastomosis of the pancreatic duct basin-jejunum was performed. Cholecystectomy was performed simultaneously for patients complicated with gallbladder stones. Postoperative recovery, incidence of complications and recurrence of the patients were observed.
Results All 11 patients completed the operation successfully. The median operation time was 3.5(2.5-4.5) h. The intraoperative blood loss was 80(50-100) ml. The postoperative extubation time was 7(3-10) d. 3 case developed biochemical fistula, which were healed after the extension of extubation time. No grade B or C pancreatic fistula occurred. No hemorrhage, abdominal infection, anastomotic fistula or death occurred. During hospitalization, 91% (10/11) of the patients presented with significant improvement in abdominal pain. During the postoperative follow-up, only 1 case suffered from the upper abdominal pain. CT scan demonstrated the changes of chronic pancreatitis. No recurrence of typical chronic pancreatitis symptoms was observed in the other patients.
Conclusion Basin-type internal drainage of the pancreatic duct can effectively treat thesub-acute chronic pancreatitis.
Key words:
Pancreatitis, chronic,
Drainage,
Postoperative complications
Meifu Chen, Yi Cai, Zhengyun Ling, Zhiqiao Zhang, Wei Cheng, Guoguang Li. Basin-type internal drainage of pancreatic duct for sub-acute chronic pancreatitis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2019, 08(04): 297-300.