Open AccessLong‐term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis
Author(s) -
Buscher H. C. J. L.,
Jansen J. B. M. J.,
van Dongen R.,
Bleichrodt R. P.,
van Goor H.
Publication year - 2002
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1046/j.1365-2168.2002.01988.x
Subject(s) - medicine , pancreatitis , thoracoscopy , surgery , visual analogue scale , anesthesia , prospective cohort study
Background: The management of pain in patients with chronic pancreatitis is difficult. The aim of this prospective study was to evaluate the early and long‐term pain relief provided by bilateral thoracoscopic splanchnicectomy. Methods: From August 1995 to August 1999, 44 patients with chronic pancreatitis underwent bilateral thoracoscopic splanchnicectomy. Data were collected prospectively. Thirty‐six patients required opioids. Pain intensity was registered before operation and at regular intervals after surgery by means of a visual analogue scale (VAS). Use of analgesics (opioids; non‐steroidal anti‐inflammatory drugs and acetaminophen; no analgesics or aminocetophen) was noted before and after splanchnicectomy. Median follow‐up was 36 (range 12–60) months. Results: The procedure was technically successful in 40 patients. Thirty‐six patients had no complications. Eleven of 24 patients who have been followed up for 24 months or more had a significantly reduced VAS score at 2 years (median (range) 8·5 (7–10) versus 2·5 (0–5); P < 0·01). The cumulative rate of pain relief was 46 per cent 48 months after splanchnicectomy. Conclusion: Bilateral thoracoscopic splanchnicectomy alleviated pain in patients with chronic pancreatitis. It was associated with a low morbidity rate and no deaths. Pain eventually recurred in approximately 50 per cent. © 2002 British Journal of Surgery Society Ltd