Long Term Results of Longitudinal Pancreatico‐Jejunostomy for Chronic Pancreatic Pain

Chronic pancreatic pain is frequently severe, recurrent and intractable. It dominates the lives of people that suffer from it. Medical management of this problem primarily involves adequate analgesia (often regular opiates) and treatment of the results of pancreatic dysfunction e.g. steatorrhoea and diabetes mellitus. Advise regarding alcohol consumption is also an important facet of conservative therapy. While this policy may prove successful in a number of patients there is a group who require frequent hospital admission for acute on chronic attacks of pain. When reviewed in the surgical clinic these patients are often seen by the most junior member of the surgical team who advises a reduction in the quantity ofboth alcohol and analgesia. In reality the patient is usually drinking comparatively little and requires the analgesia for what is intractable pain. Such patients are classified as opiate addicts, "not fit for surgical intervention". We feel that such patients should be reviewed, not necessarily in a specialist clinic, but by the consultant in charge and preferably when he has an "interest" rather than a "disinterest" in the condition. It is our experience careful selection and treatment of these patients can lead to excellent pain relief, often with the patients returning to work. Although there are a number of treatment options available which include