Use of Thoracoscopic Splanchnicectomy for the Relief of Chronic Pancreatic Pain: a Case Series
DOI:
https://doi.org/10.31436/imjm.v13i2.476Abstract
Chronic pancreatitis may cause disabling pain not responding to oral analgesics and/or drainage procedures. Although pancreatectomy is a definitive treatment, it carries a significant morbidity and mortality. Celiac plexus ablation is beneficial, although it is a temporary method for pain relief. While bilateral splanchnicectomy provides a more permanent pain relief, it is a difficult procedure requiring thoracotomy and results in significant morbidity. Thoracoscopy is an attractive alternative to perform splanchnicectomy. The results of a case series on video assisted thoracoscopic sympathectomies performed at the university surgical unit, Peradeniya, Sri Lanka from January 2011 to June 2013 was analyzed to evaluate the surgical technique and to quantify the efficacy of pain relief. Operating time, blood loss, intraoperative complications, conversion to open surgery, pre-operative and post-operative pain assessment using visual analogue scale score (VAS) were recorded. Seven patients who underwent video assisted thoracoscopic splachnicectomy were analyzed. All had an acceptable operating time (6omin), no measurable blood loss, no conversions to open surgery, no intercostal drainage, early mobilization and feeding. All had an average VAS of 8-10 pre-operatively. This reduced to a VAS of 1 or no pain in all, on post-operative day one, at one and six months. The few who experienced mild pain needed occasional use of paracetamol or diclofenac sodium. Non required narcotic analgesics. Bilateral thoracoscopic splanchnicectomy is a safe, effective and more attractive alternative as it carries a minimum morbidity, mortality and provides an excellent relief of chronic agonizing pancreatic pain.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
All material submitted for publication is assumed to be submitted exclusively to the IIUM Medical Journal Malaysia (IMJM) unless the contrary is stated. Manuscript decisions are based on a double-blinded peer review process. The Editor retains the right to determine the style and if necessary, edit and shorten any material accepted for publication.
IMJM retain copyright to all the articles published in the journal. All final ‘proof’ submissions must be accompanied by a completed Copyright Assignment Form, duly signed by all authors. The author(s) or copyright owner(s) irrevocably grant(s) to any third party, in advance and in perpetuity, the right to use, reproduce or disseminate the research article in its entirety or in part, in any format or medium, provided that no substantive errors are introduced in the process, proper attribution of authorship and correct citation details are given, and that the bibliographic details are not changed. If the article is reproduced or disseminated in part, this must be clearly and unequivocally indicated.