Mucinous Cystadenoma and Cystadenocarcinoma of the Pancreas: Possibility for Late Recurrence and Malignant Transformation

Sastre, B.; Carabalona, B.; Sahel, J; Payan, Marie-José; Agostini, S; Michotey, G

doi:10.1159/000172041

Cited by 4 publications

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“…Splanchnicectomy performed thoracoscopically obviates the morbidity and potential mortality of the counterpart open procedure. The thoracoscopic approach has been credited with promising results [11,12]. This prompted us to evaluate the potential of this procedure in the treatment of chronic pancreatic pain.…”

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confidence: 99%

Thoracoscopic Splanchnicectomy: Pilot Evaluation of a Simple Alternative for Chronic Pancreatic Pain Control

et al. 1999

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Achieving adequate pain control in patients with chronic pancreatitis remains a surgical challenge. The quest for a procedure that retains all of the residual pancreatic tissue in the absence of ductal dilatation remains elusive. This study sought to evaluate the feasibility and efficacy of thoracoscopic splanchnicectomy and attempted to outline the surgical anatomy appropriate to an adequate denervation. Of 17 patients considered suitable for the procedure, 16 had a sucessful outcome, which was statistically significant (p < 0.001). The longest follow-up of 30 months suggests that the procedure may be more enduring than percutaneous procedures. However, the surgical anatomy is not predictable owing to the racemose arrangement of the splanchnic fibers, and a long pleurotomy with transection of all medial fibers is necessary to effect denervation. Thoracoscopic splanchnicectomy may effect immediate pain relief with negligible morbidity and absent mortality. Although the follow-up period is short, the patient with the longest follow-up remains pain-free at 30 months. This procedure warrants scrutiny for its role in long-term pancreatic pain control.

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confidence: 99%