Thoracoscopic splanchnicectomy for the relief of pain due to chronic pancreatitis

Abstract

Background: Many methods have been advocated for control of pain in patients suffering from chronic pancreatitis. Some patients may be considered for pancreatic denervation. This study was performed to evaluate the effect of thoracoscopic splanchnicetomy (TS) on pain intensity and many of the common daily functions in patients with intractable pain due to chronic pancreatitis. Methods: Twenty-four thoracoscopic splanchnicectomies were performed on twenty patients. To assess pain severity and the impact of the pain, all patients completed short form using 0-10 numeric rating scale. To describe and compare the adequacy of analgesic management before and after TS the Pain Management index was used. Patients were evaluated one day prior to the operation and on monthly basis for 6 months after the procedure. Results: Pain was reduced after the operation significantly (p<0,001) and all but four patients had consistent pain relief during the postoperative follow-up. Four patients had recurrence of pain 3 months after left- sided TS; after undergoing TS on the opposite side, they were relieved of pain. The degree to which pain interfered common daily functions decreased significantly (p<0,001) after surgery, and the adequacy of the analgesic management improved.Conclusions: Thoracoscopic splanchnicectomy is a simple, minimally invasive, save procedure that appears to offer relief from pain, allow recovery of daily activities and improve the adequacy of the analgesic management.