PURPOSE: To assess prospectively the feasibility of drainage procedures in patients with chronic pancreatitis and small ducts. METHODS: Forty-five patients with chronic pancreatitis and main pancreatic ductal diameters less than 5 mm (group 1) underwent lateral pancreaticojejunostomy with varying degrees of head coring. Their outcomes were recorded and compared with 212 patients who had large ducts (diameter >7 mm; group 2). Patients in the two groups were comparable in age, etiology, presence of jaundice, diabetes, steatorrhea, head mass, pseudocysts, and biliary obstruction. RESULTS: Mortality and complication rates were similar in the two groups. Drainage procedures relieved pain in 94% (43/45 cases) in small-duct disease, and 91% (193/212) of cases with large-duct disease over a median follow-up greater than 30 months. Functional results were also comparable. CONCLUSION: In the light of these results, drainage procedures merit wider application for small-duct disease.
PURPOSE: To assess prospectively the feasibility of drainage procedures in patients with chronic pancreatitis and small ducts. METHODS: Forty-five patients with chronic pancreatitis and main pancreatic ductal diameters less than 5 mm (group 1) underwent lateral pancreaticojejunostomy with varying degrees of head coring. Their outcomes were recorded and compared with 212 patients who had large ducts (diameter >7 mm; group 2). Patients in the two groups were comparable in age, etiology, presence of jaundice, diabetes, steatorrhea, head mass, pseudocysts, and biliary obstruction. RESULTS: Mortality and complication rates were similar in the two groups. Drainage procedures relieved pain in 94% (43/45 cases) in small-duct disease, and 91% (193/212) of cases with large-duct disease over a median follow-up greater than 30 months. Functional results were also comparable. CONCLUSION: In the light of these results, drainage procedures merit wider application for small-duct disease.
Authors: Michol A Cooper; Martin A Makary; Julie Ng; Yunfeng Cui; Vikesh K Singh; Karen Matsukuma; Dana K Andersen Journal: J Gastrointest Surg Date: 2013-01-24 Impact factor: 3.452