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Partington-rochelle : When to drain the pancreatic duct and why

Andrén-Sandberg, Åke LU and Hafström, Anna LU (1996) In Digestive Surgery 13(2). p.109-112
Abstract

Chronic pancreatitis should be managed medically until a surgical correctable complication develops. The ‘ideal’ operation should have a low mortality and morbidity, be easy to perform, provide pain relief, rectify the structural abnormalities such as bile duct obstruction, and not augment exocrine and endocrine insufficiency. Direct measurements made at the time of laparotomy have shown that at least some patients with chronic pancreatitis and dilated ducts or pseudocysts had raised intraductal pressure. Drainage operations for chronic pancreatitis are based on the concept that obstruction of the main pancreatic duct(s) leads to an increased intraductal and intraparenchymal pressure, and that this, in turn, gives rise to pain. For a... (More)

Chronic pancreatitis should be managed medically until a surgical correctable complication develops. The ‘ideal’ operation should have a low mortality and morbidity, be easy to perform, provide pain relief, rectify the structural abnormalities such as bile duct obstruction, and not augment exocrine and endocrine insufficiency. Direct measurements made at the time of laparotomy have shown that at least some patients with chronic pancreatitis and dilated ducts or pseudocysts had raised intraductal pressure. Drainage operations for chronic pancreatitis are based on the concept that obstruction of the main pancreatic duct(s) leads to an increased intraductal and intraparenchymal pressure, and that this, in turn, gives rise to pain. For a long time a longitudinal pancreaticojejunostomy according to Partington and Rochelle, i.e. the duct of Wirsung opened from tail of pancreas to the duodenum and anastomosed to the side of the jejunum, has been one of the techniques that has been used most often. There is little evidence that the procedure delays the development of endocrine and exocrine insufficiency. This implies that this option should not be chosen early in the disease, but rather when pain control is out of hand after medical management.

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author
and
publishing date
type
Contribution to journal
publication status
published
keywords
Chronic pancreatitis, Pain, Pancreaticojejunostomy, Surgery
in
Digestive Surgery
volume
13
issue
2
pages
4 pages
publisher
Karger
external identifiers
  • scopus:0029945806
ISSN
0253-4886
DOI
10.1159/000172416
language
English
LU publication?
no
id
52eabc6b-e52a-4a00-9739-2804ddf5bb8b
date added to LUP
2020-05-09 08:37:08
date last changed
2020-05-11 11:26:11
@article{52eabc6b-e52a-4a00-9739-2804ddf5bb8b,
  abstract     = {<p>Chronic pancreatitis should be managed medically until a surgical correctable complication develops. The ‘ideal’ operation should have a low mortality and morbidity, be easy to perform, provide pain relief, rectify the structural abnormalities such as bile duct obstruction, and not augment exocrine and endocrine insufficiency. Direct measurements made at the time of laparotomy have shown that at least some patients with chronic pancreatitis and dilated ducts or pseudocysts had raised intraductal pressure. Drainage operations for chronic pancreatitis are based on the concept that obstruction of the main pancreatic duct(s) leads to an increased intraductal and intraparenchymal pressure, and that this, in turn, gives rise to pain. For a long time a longitudinal pancreaticojejunostomy according to Partington and Rochelle, i.e. the duct of Wirsung opened from tail of pancreas to the duodenum and anastomosed to the side of the jejunum, has been one of the techniques that has been used most often. There is little evidence that the procedure delays the development of endocrine and exocrine insufficiency. This implies that this option should not be chosen early in the disease, but rather when pain control is out of hand after medical management.</p>},
  author       = {Andrén-Sandberg, Åke and Hafström, Anna},
  issn         = {0253-4886},
  language     = {eng},
  month        = {01},
  number       = {2},
  pages        = {109--112},
  publisher    = {Karger},
  series       = {Digestive Surgery},
  title        = {Partington-rochelle : When to drain the pancreatic duct and why},
  url          = {http://dx.doi.org/10.1159/000172416},
  doi          = {10.1159/000172416},
  volume       = {13},
  year         = {1996},
}