Document Detail


Outcome after lateral pancreaticojejunostomy for chronic pancreatitis.
MedLine Citation:
PMID:  8185399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the outcome of lateral pancreaticojejunostomy in patients with chronic pancreatitis. SUMMARY BACKGROUND DATA: Chronic fibrocalcific pancreatitis associated with pancreatic ductal dilation and chronic pain has been managed successfully with lateral pancreaticojejunostomy. Early results, measured by pain relief and postoperative morbidity and mortality, have been excellent; however, long-term follow-up and overall outcome has been less clearly defined in these patients. METHODS: The outcome of 85 patients who had lateral pancreaticojejunostomy was assessed by reviewing hospital inpatient and outpatient records and conducting patient telephone interviews. RESULTS: Of 62 patients who were alive at follow-up, health status was characterized as good in 24%, fair in 31%, and poor in 45%. Alcohol abuse continued in 42% of patients, whereas narcotic use continued in 35%, insulin use continued in 23%, and pancreatic enzyme supplementation continued in 34%. Rehospitalization for recurrent attacks of pancreatitis and pain was necessary in 40% of patients. Six patients required subsequent operations for complications of chronic pancreatitis. Death occurred in 22 patients (26%) and resulted from continued alcohol abuse, progression of chronic pancreatitis, or late complications of the operation in more than one half the cases. CONCLUSIONS: Although lateral pancreaticojejunostomy provided pain relief, had a low morbidity rate, and no early postoperative deaths, long-term outcome was poor based on the patient's health status, continued alcohol and narcotic use, employment status, subsequent hospitalization to treat recurrent pancreatitis or its complications, subsequent operations required for complications of chronic pancreatitis, and postoperative deaths related to comorbid medical conditions or complications of chronic pancreatitis.
Authors:
D B Adams; M C Ford; M C Anderson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  219     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-14     Completed Date:  1994-06-14     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  481-7; discussion 487-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Medical University of South Carolina, Charleston.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cause of Death
Chronic Disease
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pancreaticojejunostomy*
Pancreatitis / etiology,  mortality,  surgery*
Postoperative Complications
Recurrence
Survival Rate
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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