Surgical Management of Chronic Pancreatitis

Abstract

Advances over the past decade have indicated that a complex interplay between environmental factors, genetic predisposition, alcohol abuse, and smoking lead towards the development of chronic pancreatitis. Chronic pancreatitis is a complex disorder that causes significant and chronic incapacity in patients and a substantial burden on the society. Major advances have been made in the etiology and pathogenesis of this disease and the role of genetic predisposition is increasingly coming to the fore. Advances in noninvasive diagnostic modalities now allow for better diagnosis of chronic pancreatitis at an early stage of the disease. The impact of these advances on surgical treatment is beginning to emerge, for example, patients with certain genetic predispositions may be better treated with total pancreatectomy versus lesser procedures. Considerable controversy remains with respect to the surgical management of chronic pancreatitis. Modern understanding of the neurobiology of pain in chronic pancreatitis suggests that a window of opportunity exists for effective treatment of the intractable pain after which central sensitization can lead to an irreversible pain syndrome in patients with chronic pancreatitis. Effective surgical procedures exist for chronic pancreatitis; however, the timing of surgery is unclear. For optimal treatment of patients with chronic pancreatitis, close collaboration between a multidisciplinary team including gastroenterologists, surgeons, and pain management physicians is needed.

A mountable toilet system for personalized health monitoring via the analysis of excreta

“…Uroflowmetry is used as a diagnostic test to assess the function of the urinary tract. Stool analysis is also important for diagnosing gastrointestinal disorders, including poor nutrient absorption 27 , pancreatitis [28][29][30][31][32][33] , infections [34][35][36] and cancers 17,37,38 . In particular, the Bristol stool form scale (BSFS; BS1-BS7) categorizes the form of stool to be used as an assessment tool for the diagnosis of various bowel diseases or evaluation of treatment efficacy (Supplementary Table 1).…”

Long Term Follow-up Results of Surgical Management of Chronic Pancreatitis

“…Regarding the evaluation of outcomes, visual analogue pain scale was used for pain control evaluation. The 12-Item Short-Form General Health Survey (SF-12) questionnaire was used for quality of life assessment (7). Dosage of serum glycated hemoglobin, peptide-C and measure of fat fecal content by Sudanstain test were used to assess endocrine and exocrine pancreatic function.…”

A Clinical Overview of Acute and Chronic Pancreatitis: The Medical and Surgical Management

“…The Frey procedure consists of excising the anterior head of the pancreas, including the major and minor pancreatic ducts and the duct of Santorini, with preservation of the posterior pancreatic head and the pancreatic neck [51]. Additionally, the main pancreatic duct is opened, and a Roux-en-Y limb is brought up to complete a pancreaticojejunostomy [51]. Studies have shown that post-operative morbidity in the Frey procedure ranges from 7.5% to 39%, with mortality rates ranging from 0% and 2.4% [51,[54][55][56].…”