Laparoscopic longitudinal pancreaticojejunostomy for chronic pancreatitis: Systematic review of the literature |
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| Affiliation: | 1. Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Guadalajara, Guadalajara, Spain;2. Department of Surgery, Centre Hospitalier du Luxembourg, Luxembourg;1. Department of Surgery, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;2. Institute of Oncology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;1. Trainees'' Committee, Royal College of Surgeons of Edinburgh, Edinburgh, UK;2. Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK;3. Health Education England Yorkshire and the Humber, Leeds, UK;4. Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK;5. Department of Vascular Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK;6. Department of Ear, Nose and Throat Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK;7. Department of Breast Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK;8. Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK;9. Health Education England North West, Manchester, UK;10. Pfizer Pharma GmbH, Berlin, Germany;1. Department of Surgery, University of Cambridge, Cambridge, UK;2. Human Anatomy Teaching Group, Department of Physiology, Development and Neurosciences, University of Cambridge, Cambridge, UK |
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| Abstract: | BackgroundLongitudinal pancreaticojejunostomy, also known as modified Puestow or Partington-Rochelle procedure, is a technique for the treatment of chronic pancreatitis. It is usually performed by laparotomy, but in a very small number of cases it has been performed using a laparoscopic or robot-assisted approach. We carried out a systematic literature review to clarify the current status of laparoscopic longitudinal pancreatojejunostomy (LLPJ).MethodsAdhering to the PRISMA guidelines, a systematic search for LLPJ was performed in PubMed, Embase, and Cochrane Library, for articles published up to 31 December 2017.Results357 articles were evaluated for eligibility and 17 were included for critical appraisal: eight case reports, eight retrospective case series, and one series of cases and controls without randomization. All of them had a grade of recommendation C and a level of evidence 4 according to the CEBM. Patients were relatively young (mean age 37 years), with a slight preponderance of males (ratio 1.3: 1). All had long-standing disease, ERCP prior to surgery and a dilated pancreatic duct (mean 11 mm). The surgery was usually performed laparoscopically using four trocars; the conversion rate was low (5%), bleeding was minimal, the morbidity rate was 11% and no mortality was reported. Mean hospital stay was 5.6 days. The follow-up period varied but was usually short (less than two years). The results for pain control were very good since 90% of patients reported no pain, although visual analog scales were rarely used.ConclusionsIn conclusion, LLPJ seems to be a safe, feasible and effective technique in patients with chronic pancreatitis. However, the number of descriptions published to date is very small, and there are no studies with high scientific evidence comparing LLPJ with open surgery or with endoscopic treatment that would allow us to draw firmer conclusions at the present time. |
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| Keywords: | Pancreatitis, Chronic Laparoscopy Robotic Surgical Procedures Pancreaticojejunostomy Puestow |
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