Cargando…
A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure
BACKGROUND: The treatment of chronic pancreatitis requires a surgical approach in patients who are refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duc...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891013/ https://www.ncbi.nlm.nih.gov/pubmed/33602183 http://dx.doi.org/10.1186/s12893-021-01096-4 |
_version_ | 1783652615394951168 |
---|---|
author | Saito, Kenta Matsuo, Yoichi Ueda, Goro Omi, Kan Hayashi, Yuichi Imafuji, Hiroyuki Tsuboi, Ken Morimoto, Mamoru Ogawa, Ryo Takahashi, Hiroki Naitoh, Itaru Hayashi, Kazuki Kataoka, Hiromi Takiguchi, Shuji |
author_facet | Saito, Kenta Matsuo, Yoichi Ueda, Goro Omi, Kan Hayashi, Yuichi Imafuji, Hiroyuki Tsuboi, Ken Morimoto, Mamoru Ogawa, Ryo Takahashi, Hiroki Naitoh, Itaru Hayashi, Kazuki Kataoka, Hiromi Takiguchi, Shuji |
author_sort | Saito, Kenta |
collection | PubMed |
description | BACKGROUND: The treatment of chronic pancreatitis requires a surgical approach in patients who are refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Indeed, suboptimal procedures lead to recurrent pancreatitis. We used a laparoscopic hybrid approach for patients with severe stenosis of the pancreatic duct. In this report, we present the feasibility and outcomes of our approach. METHODS: We selected a laparoscopic approach for the distal pancreatectomy, which is relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We recorded the operative outcomes, postoperative complications, and recurrence of pancreatitis. RESULTS: We performed the laparoscopic hybrid approach on 3patients between January and December 2018. There were no major intraoperative complications (Clavien-Dindo classification IIIa or more) and the postoperative course was uneventful in all patients. There were no recurrences of pancreatitis and no postoperative pain in all patients in > 2 years of follow-up. CONCLUSION: Our hybrid method with a focus on complete ductal compression with safety and minimal invasiveness might be the optimal approach for the surgical treatment of chronic pancreatitis that requires a pancreatectomy with the Frey procedure. |
format | Online Article Text |
id | pubmed-7891013 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78910132021-02-22 A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure Saito, Kenta Matsuo, Yoichi Ueda, Goro Omi, Kan Hayashi, Yuichi Imafuji, Hiroyuki Tsuboi, Ken Morimoto, Mamoru Ogawa, Ryo Takahashi, Hiroki Naitoh, Itaru Hayashi, Kazuki Kataoka, Hiromi Takiguchi, Shuji BMC Surg Technical Advance BACKGROUND: The treatment of chronic pancreatitis requires a surgical approach in patients who are refractory to medical therapy. During surgical treatment, ductal decompression is required, but a pancreatectomy is necessary for some patients, such as those with severe stenosis of the pancreatic duct. Indeed, suboptimal procedures lead to recurrent pancreatitis. We used a laparoscopic hybrid approach for patients with severe stenosis of the pancreatic duct. In this report, we present the feasibility and outcomes of our approach. METHODS: We selected a laparoscopic approach for the distal pancreatectomy, which is relatively safe and the effect of reducing the length of the wound is substantial. We selected an open approach for the Frey procedure because complete ductal compression has a high risk for injury to the vessels posterior to the pancreas. We recorded the operative outcomes, postoperative complications, and recurrence of pancreatitis. RESULTS: We performed the laparoscopic hybrid approach on 3patients between January and December 2018. There were no major intraoperative complications (Clavien-Dindo classification IIIa or more) and the postoperative course was uneventful in all patients. There were no recurrences of pancreatitis and no postoperative pain in all patients in > 2 years of follow-up. CONCLUSION: Our hybrid method with a focus on complete ductal compression with safety and minimal invasiveness might be the optimal approach for the surgical treatment of chronic pancreatitis that requires a pancreatectomy with the Frey procedure. BioMed Central 2021-02-18 /pmc/articles/PMC7891013/ /pubmed/33602183 http://dx.doi.org/10.1186/s12893-021-01096-4 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Technical Advance Saito, Kenta Matsuo, Yoichi Ueda, Goro Omi, Kan Hayashi, Yuichi Imafuji, Hiroyuki Tsuboi, Ken Morimoto, Mamoru Ogawa, Ryo Takahashi, Hiroki Naitoh, Itaru Hayashi, Kazuki Kataoka, Hiromi Takiguchi, Shuji A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure |
title | A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure |
title_full | A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure |
title_fullStr | A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure |
title_full_unstemmed | A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure |
title_short | A hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open Frey procedure |
title_sort | hybrid approach for chronic pancreatitis: combination of laparoscopic assisted distal pancreatectomy and open frey procedure |
topic | Technical Advance |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891013/ https://www.ncbi.nlm.nih.gov/pubmed/33602183 http://dx.doi.org/10.1186/s12893-021-01096-4 |
work_keys_str_mv | AT saitokenta ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT matsuoyoichi ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT uedagoro ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT omikan ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT hayashiyuichi ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT imafujihiroyuki ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT tsuboiken ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT morimotomamoru ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT ogawaryo ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT takahashihiroki ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT naitohitaru ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT hayashikazuki ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT kataokahiromi ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT takiguchishuji ahybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT saitokenta hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT matsuoyoichi hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT uedagoro hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT omikan hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT hayashiyuichi hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT imafujihiroyuki hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT tsuboiken hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT morimotomamoru hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT ogawaryo hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT takahashihiroki hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT naitohitaru hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT hayashikazuki hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT kataokahiromi hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure AT takiguchishuji hybridapproachforchronicpancreatitiscombinationoflaparoscopicassisteddistalpancreatectomyandopenfreyprocedure |