The management of opiate-dependent intractable abdominal pain caused by chronic pancreatitis remains challenging.
Dr Saleh Baghdadi and colleagues from the United Kingdom reviewed the published series on the role, safety, feasibility, and efficacy of thoracoscopic splanchnicectomy.
|The mean success rate was 90% up to 6 months of follow-up|
The team searched the MEDLINE, EMBASE, and PREMEDLINE databases, and relevant English language publications were systematically retrieved.
Data were pooled by 2 independent reviewers.
The researcher found that between 1994 and 2006, 302 patients were featured in 16 reports.
The reports described 202 procedures as bilateral, and 100 as unilateral.
The research team identified morbidity in 17%, conversion to thoracotomy in 1%, reoperation to manage complications in 1%, and 0% mortality.
The mean postoperative hospital stay was 3 days.
The team found the mean success rate was 90% up to 6 months of follow-up evaluation.
At 6 to 15 months of follow-up, the success rates was 75%, and after 15 months to 6 years, the success rate was 49%.
Further intervention for pain relief was required for 13% of the patients.
Dr Baghdadi's team concluded, "Splanchnicectomy reduces pain and improves quality of life for patients with chronic pancreatitis."
"Patient selection determines success rates, but the early good results achieved decline with time elapsed after thoracoscopic splanchnicectomy."