Rege SA*, Kulkarni GV, Surpam Shrinivas, Amiteshwar Singh and Chiranjeev R
Department of General Surgery, King Edward Memorial Hospital, IndiaFulltext PDF
Introduction: Lateral Pancreaticojejunostomy (LPJ), has its recognized applications in the decompressive management of Chronic Pancreatitis (CP), and is recommended in patients with concomitant pain, obstructed, dilated pancreatic duct. Performing this procedure laparoscopically is technically challenging. We describe our technique and report our series of 33 patients who underwent this procedure.Methods: Between March 2013 and June 2018, 33 patients (19 males, 14 females) hailing from 5 different states in India, with an established diagnosis of CP underwent laparoscopic LPJ by a single surgeon in a tertiary care center in Western India. The median age and pancreatic duct diameter on CT were 41.8 (22 to 54) years and 8.73 (7 to 10) mm, respectively.Results: Thirty two patients were included in the final analysis in which the procedure was completed laparoscopically while one surgery necessitated conversion to open, owing to hemorrhage from the gastroduodenal artery. Median operating time was 131.2 (104 to 163) minutes and intraoperative blood loss of approximately 100 mL. There were no peri-operative deaths and no mortality at the six month follow up. No peri-operative blood transfusion was required, and the median postoperative hospital stay was 5.25 (5 to 8) days. Two patients required readmission at 8 months for pain. Twenty four patients reported to be nearly pain free on follow up while remaining 8 patients were managed with appropriate analgesia without further procedures.Conclusion: Laparoscopic LPJ is feasible and can be performed safely in carefully selected patients in experienced hands. Our series shows good short-term outcomes and all the known benefits of laparoscopy which might entirely replace open pancreatic surgery in the future.
Rege SA, Kulkarni GV, Shrinivas S, Singh A, Chiranjeev R. Laparoscopic Lateral Pancreaticojejunostomy for Chronic Pancreatitis; a Single Operator Tertiary Center Experience from Western India. Clin Surg. 2019; 4: 2310.