Journal article
Long-term follow-up of thoracoscopic splanchnicectomy for chronic pancreatitis pain
Surgical endoscopy, Vol.15(7), pp.706-709
2001
DOI: 10.1007/s004640080093
PMID: 11591972
Abstract
Background: Thoracoscopic splanchnicectomy (SPL) has been reported to give excellent short-term pain relief in chronic pancreatitis. This study prospectively evaluates the long-term efficacy of SPL in pancreatitis patients.
Methods: Chronic pancreatitis patients with severe pain unrelieved by standard therapy completed a standard 10-point analogue pain scale prior to surgery and at postoperative visits. Midline and left-sided pain was treated with left SPL; right-sided pain was treated with right SPL. If pain recurred on the contralateral side, contralateral SPL was done.
Results: Fifteen patients underwent SPL. Eleven of them required narcotics preoperatively. Follow-up is complete and ranges from 4.2 to 6.1 years (median, 5.75). All patients had constant pain prior to surgery. Following SPL, it decreased in the short term to a mean of 3.9 attacks a month. At long-term follow-up, the mean number of attacks was 8.6 per month. Preoperatively, the mean score for worst pain within the last 2 months was 9.1. This score decreased to 3.9, but at long-term follow-up it had increased to near preoperative values (8.6). Current severity of pain decreased from 7.2 preoperatively to 2.9 at short-term follow-up, but at long-term follow-up it had increased. The degree of disability decreased from 9.1 preoperatively to 5.1 at short-term follow-up, but in the long term it increased toward preoperative values. Although eight patients were narcotic free at early follow-up, only three remained narcotic free in the long-term.
Conclusion: Thoracoscopic SPL offers short-term relief of pain from chronic pancreatitis, but the relief is not durable in most cases. Similarly, there are short-term improvements in degree of disability, mood, and freedom from narcotic use that are not sustained in the long-term. Nevertheless, two-thirds of patients stated that they would have the surgery again.
Details
- Title: Subtitle
- Long-term follow-up of thoracoscopic splanchnicectomy for chronic pancreatitis pain
- Creators
- J. W MAHER - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United StatesF. C JOHLIN - Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United StatesD HEITSHUSEN - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- Surgical endoscopy, Vol.15(7), pp.706-709
- Publisher
- Springer
- DOI
- 10.1007/s004640080093
- PMID
- 11591972
- ISSN
- 0930-2794
- eISSN
- 1432-2218
- Language
- English
- Date published
- 2001
- Academic Unit
- Gastroenterology and Hepatology; Surgery; Internal Medicine
- Record Identifier
- 9984094596802771
Metrics
14 Record Views