Laparoscopic Lateral Pancreatico-jejunostomy: An Experience from a Tertiary Care Center

Abstract

Background: Surgical options for patients of chronic pancreatitis with refractory pain include drainage and/or resectional procedures. Lateral pancreatojejunostomy (LPJ), the commonly performed drainage operation has traditionally been done as open procedure. Laparoscopic LPJ is a technically demanding procedures and is presently gaining acceptance in many centers. Patients and methods: Retrospective analysis of prospectively maintained patient database of chronic pancreatitis at our center from January 2007 to April 2018. Results: During the study period, 41 patients underwent laparoscopic LPJ and constituted the study group. Of the 41 patients, 26 were male.Their mean age was 30.7 (7-51) years. Pain was the main indication of surgery. Nine patients had diabetes and 6 had steatorrhea. The mean MPD diameter was 13.6 (8-25) mm. The mean duration of surgery was 180 (140-340) min and blood loss was 110 ml. There was no mortality. Postoperative hospital stay was 5 (3-9) days and satisfactory pain relief was seen in 91% on at least 3 months follow-up. Follow-up period ranged from 1 to 109 months (average-43.6 months). Conclusions: Laparoscopic LPJ is feasible and safe with good short and long-term outcomes in selected groups of patients.However, it is a technically demanding procedure and should be done by a surgeon well versed with laparoscopic skills including suturing and knotting..