[Splanchnicectomy by Dubois' transhiatal approach. Technics, indications and results. Apropos of 25 nerve sections for visceral abdominal pain].

Splanchnicectomy through Dubois, transhiatal approach was performed in 25 patients with abdominal pain of mainly pancreatic origin. The four stages of the operation are described and are facilitated by the use of a Fruchaud type of retractor and rigid, long, narrow valves to enable lateral displacement of the aorta and abdominal esophagus. After dissection of the esophageal hiatus, the Xth nerves and abdominal esophagus are isolated and the pleura detached, beginning with the anterior surface of the aorta. The greater splanchnic nerves are then isolated and sectioned and a final-stage esophageal hiatus reconstruction performed. This simple, rapid technique produces immediate, total, lasting pain relief, particularly spectacular in patients with cancer of the body of the pancreas, this representing the indication of choice for this neurectomy. Splanchnicectomy does not affect survival duration but improves the comfort and quality of this period. In hyperalgic forms of chronic pancreatitis, this nerve section can be combined with conventional surgery. There was no operative mortality in this series of 25 cases.