‘Short’pancreaticojejunostomy might be a valid option for treatment of chronic pancreatitis in many cases  

作　　者：Marko Murruste Ülle Kirsimägi Karri Kase Tatjana Veršinina Peep Talving Urmas Lepner 

机构地区：[1]Department of Surgery,Tartu University Hospital,Tartu 50406,Estonia [2]Faculty of Medicine,University of Tartu,Tartu 50411,Estonia [3]Division of Acute Care Surgery,Department of Surgery,North-Estonia Medical Centre,Tallinn 13419,Estonia

出　　处：《World Journal of Gastrointestinal Surgery》2021年第12期1673-1684,共12页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND The Partington-Rochelle pancreaticojejunostomy(PJ)is an essential management option for patients with chronic pancreatitis(CP)associated with intractable pain and a dilated pancreatic duct(PD).Wide ductotomy and long PJ(L-PJ)have been advocated as the standard of care to ensure full PD decompression.However,the role of short PJ(S-PJ)in a uniformly dilated PD has not yet been evaluated.AIM To evaluate the possible advantages and disadvantages of S-PJ and L-PJ and to interpret the perspective of S-PJ in the treatment of CP.METHODS A retrospective review of prospectively collected cohort data was conducted on surgically treated CP patients subjected to side-to-side PJ.The length of the PJ was adapted to anatomical alterations in PD.A comparison was made of S-PJ(<50 mm)for uniformly dilated PD and L-PJ(50-100 mm)in the setting of multiple PD strictures,calcifications and dilatations.We hypothesized that S-PJ and L-PJ ensure comparable clinical outcomes.The primary outcomes were pain relief and quality of life(QOL);the secondary outcomes were perioperative characteristics,body weight,patients’satisfaction with treatment,and readmission rate due to CP.RESULTS Overall,91 patients underwent side-to-side PJ for CP,including S-PJ in 46 patients and L-PJ in 45 patients.S-PJ resulted in better perioperative outcomes:Significantly shorter operative time(107.5 min vs 134 min),lower need for intraoperative(0%vs 15.6%)and total(2.2%vs 31.1%)blood transfusions,and lower rate of perioperative complications(6.5%vs 17.8%).We noted no significant difference in pain relief,improvement in QOL,body weight gain,patients’satisfaction with surgical treatment,or readmission rate due to CP.CONCLUSION Based on our data,in the setting of a uniformly dilated PD,S-PJ provides adequate decompression of the PD.As the clinical outcomes following S-PJ are not inferior to those of L-PJ,S-PJ should be preferred as a surgical option in the case of a uniformly dilated PD.

关 键 词：Chronic pancreatitis Surgical treatment PANCREATICOJEJUNOSTOMY Partington-Rochelle Length of anastomosis 

分 类 号：R657.51[医药卫生—外科学]