Customised Study of Management Strategies in Patients with Chronic Pancreatitis - Single Centre Experience
T. Narayanarao *
Andhra Medical College, King George Hospital, Visakhapatnam, Andhra Pradesh, India.
Akkidas Suvarchala
Andhra Medical College, Visakhapatnam, Andhra Pradesh-530002, India.
Karuna Sudha
Andhra Medical College, Visakhapatnam, Andhra Pradesh-530002, India.
K. Sai Krishna
Andhra Medical College, Visakhapatnam, Andhra Pradesh-530002, India.
T. Aditya
Maharaja institute of Medical sciences, Vizianagaram District, Andhra Pradesh-535217, India.
*Author to whom correspondence should be addressed.
Abstract
Despite advanced developments are available for managing patients with chronic pancreatitis, the disease remains an enigmatic process of uncertain pathogenesis with unpredictable clinical course and management. In the majority of the cases, intractable pain is a major indication for surgical intervention. Other complications related to adjacent organs such as, pancreatic pseudocysts cases, ductal pathology, intractable internal pancreatic fistula or suspected malignancy also require surgery. The surgical drainage approach should address the above problems tailoring to the various therapeutic options to meet individual patient's needs by duodenum-preserving pancreatic head resection in terms of an extended drainage procedure. In this process, the pancreas may be tailored to the morphology of the pancreatic gland. The present work is a randomised study done on 110 patients (1995-2010) with alcoholic and tropical chronic pancreatitis. Patients were subjected to both surgical and endoscopic procedures according to the inclusion criteria for both procedures. These results were compared in terms of pain and hospital stay. This study concludes that surgical procedure is far superior to endoscopic drainage for avoiding complications and pain in chronic pancreatitis.
Keywords: Chronic pancreatitis, tropical pancreatitis, ductal hypertension, pseudocysts, pancreatic ascites, chronic pain abdomen, Pancreatico-jejunostomy