Detailed Abstract
[BP Best video Presentation - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP BV-S3] Laparoscopic Modified Frey's Procedure With,choledochojejunostomy-Chrnonic Calcific Pancreatistis with Common Bile Duct Stricture
K VIJAYA KUMAR 1, MAHARAJ RAJIV 1, Y. RAGHU NANDAN 1, N. ANAND VIJAI 1, V. NALANKILLI 1, P. SENTHILNATAHAN 1, CHINNUSAMY PALANIVELU 1
1 Division of HPB, Minimal Access Surgery And Liver Transplant, GEM HOSPITAL AND RESEARCH INSTITUTE, INDIA
Background : Frey's procedure has become a standard of care in patients with painful Chronic calcific pancreatitis, requiring concomitant biliary drainage for refractory bile duct obstruction. Laparoscopic management of such cases are hardly described in literature.
Methods : We present a ,59 male with painful chronic calcific pancreatitis and distal CBD stricture . ERCP and stenting was done . Patient developed recurrent attacks of Cholangitis. CECT showed intraductal calculus in head measuring 9mm ,dialated MPD 12mm. Intraoperatively Pancreas was exposed from head to tail and under IOUS guidance MPD was identified and opened.Intraductal stones was removed.Head coring was done .Roux loop of jejunum 25 cm from DJ flexure was brought through the mesocolic rent and side to side Pancreaticojejunostomy was done with 2-0 pds.Choledochojejunostomy was done with 4-0 PDS with same jejunal limb.Jejunojejunostomy was done.Post opertaive period was uneventful and patient was discharged on POD 5
Results : We did an observational retrospective cohort study of patients who underwent laparoscopic Modified Frey's surgery for chronic calcific pancreatitis between January 2006 and April 2017. 30 patients underwent this procedure .The mean(s.d.) age of the analysed cohort was 34⋅2(3⋅7) years and there was a predominance of men (34, 63 per cent). Adequate pain relief was achieved in 91, 89 and 88 per cent of patients at 1, 3 and 5 years of follow-up respectively.
Conclusions : Laparoscopic surgical management of chronic calcific pancreatitis with Modified Frey’s procedure is feasible, safe and effective in selected patients for the relief of pain.
Methods : We present a ,59 male with painful chronic calcific pancreatitis and distal CBD stricture . ERCP and stenting was done . Patient developed recurrent attacks of Cholangitis. CECT showed intraductal calculus in head measuring 9mm ,dialated MPD 12mm. Intraoperatively Pancreas was exposed from head to tail and under IOUS guidance MPD was identified and opened.Intraductal stones was removed.Head coring was done .Roux loop of jejunum 25 cm from DJ flexure was brought through the mesocolic rent and side to side Pancreaticojejunostomy was done with 2-0 pds.Choledochojejunostomy was done with 4-0 PDS with same jejunal limb.Jejunojejunostomy was done.Post opertaive period was uneventful and patient was discharged on POD 5
Results : We did an observational retrospective cohort study of patients who underwent laparoscopic Modified Frey's surgery for chronic calcific pancreatitis between January 2006 and April 2017. 30 patients underwent this procedure .The mean(s.d.) age of the analysed cohort was 34⋅2(3⋅7) years and there was a predominance of men (34, 63 per cent). Adequate pain relief was achieved in 91, 89 and 88 per cent of patients at 1, 3 and 5 years of follow-up respectively.
Conclusions : Laparoscopic surgical management of chronic calcific pancreatitis with Modified Frey’s procedure is feasible, safe and effective in selected patients for the relief of pain.
SESSION
BP Best video Presentation
Room A 3/23/2024 8:30 AM - 9:30 AM