Partington-Rochelle modified procedure of pancreatotomy with short pancreaticojejunostomy for groove pancreatitis: a technical note.

Abstract

Groove pancreatitis (GP) is a chronic segmental pancreatitis which leads to altered pancreatic secretions and pancreatitis. The exact pathogenesis of GP has not been clearly identified to date but heavy smoking and chronic alcohol consumption seem to be the main factors involved. The resulting chronic pancreatitis (CP) is a debilitating disease causing abdominal pain often refractory to medical therapy, so much that the main indication for surgical treatment is intractable abdominal pain. A growing number of increasingly complex and diverse surgical operations for the treatment of this disease were reported. Operative procedures for CP are currently grouped into decompression procedures and pancreatic resections. No consensus about which one leads to the best outcomes, but every case should be tailored to specific clinical scenarios and single individuals. We report the case of a 44-year-old man with intractable abdominal pain due to GP underwent to Partington-Rochelle modified procedure. A Wirsung-jejunal side-to-side anastomosis as described by Partington-Rochelle was performed but with two variations: the first was the length of the anastomosis which was < 50 mm (short anastomosis), while the second was the placement of two removable Bracci stent tube 6 Fr to drain respectively the distal and the proximal-medium part of Wirsung duct. The post-operative course was uneventful with good pain control. During follow-up no evidence of any radiologic signs of infection or fluid collections or pancreatic fistula nor recrudescent of abdominal pain. Nowadays a uniform approach to this pathology still is lacking. Although surgery can be carried out with satisfactory results in specialized centers, the specifical operation type should be tailored to every single cases.