کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6217444 | 1273762 | 2013 | 5 صفحه PDF | دانلود رایگان |
PurposeTo present our experience with the modified Puestow procedure in the management of children with chronic pancreatitis.MethodsRetrospective chart review of patients treated between 2003 and 2012.ResultsSix patients underwent a modified Puestow procedure (lateral pancreaticojejunostomy) for the management of chronic pancreatitis, three females and three males. Four patients had hereditary pancreatitis (three with confirmed N34S mutation in the SPINK1 gene), one patient had chronic pancreatitis of unknown etiology, and one patient with annular pancreas developed obstructive chronic pancreatitis. The pancreatic duct was dilated in all cases, with a maximum diameter of 5 to 10Â mm. Median time between onset of pain and surgery was 4Â years (range: 1-9). Median age at surgery was 7.5Â years (range: 5-15). Median hospital stay was 12Â days (range: 9-28). Median follow up was 4.5Â years (range: 5Â months to 9Â years). All patients had temporary postoperative improvement of their abdominal pain. In two patients the pain recurred at 6Â months and 2Â years postoperatively and eventually required total pancreatectomy to treat intractable pain, 3 and 8Â years after surgery. Two patients were pain free for two years and subsequently developed occasional episodes of pain. The two most recent patients are pain free at 1Â year (obstructive chronic pancreatitis) and 5Â months (hereditary pancreatitis) follow-up. Two patients developed type I diabetes mellitus 10 and 12Â months postoperatively (one with hereditary and one with idiopathic chronic pancreatitis).ConclusionWe conclude that the modified Puestow procedure in children is feasible and safe. It seems to provide definitive pain control and prevent further damage to the pancreas in patients with obstructive chronic pancreatitis. However, in patients with hereditary pancreatitis, pain control outcomes are variable and the operation may not abrogate the progression of disease to pancreatic insufficiency.
Journal: Journal of Pediatric Surgery - Volume 48, Issue 11, November 2013, Pages 2271-2275