title: Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis.
abstract: BACKGROUND
  The management of pain in patients with chronic pancreatitis is difficult. The aim of this prospective study was to evaluate the early and long-term pain relief provided by bilateral thoracoscopic splanchnicectomy.
  
  
  METHODS
  From August 1995 to August 1999, 44 patients with chronic pancreatitis underwent bilateral thoracoscopic splanchnicectomy. Data were collected prospectively. Thirty-six patients required opioids. Pain intensity was registered before operation and at regular intervals after surgery by means of a visual analogue scale (VAS). Use of analgesics (opioids; non-steroidal anti-inflammatory drugs and acetaminophen; no analgesics or aminocetophen) was noted before and after splanchnicectomy. Median follow-up was 36 (range 12-60) months.
  
  
  RESULTS
  The procedure was technically successful in 40 patients. Thirty-six patients had no complications. Eleven of 24 patients who have been followed up for 24 months or more had a significantly reduced VAS score at 2 years (median (range) 8.5 (7-10) versus 2.5 (0-5); P < 0.01). The cumulative rate of pain relief was 46 per cent 48 months after splanchnicectomy.
  
  
  CONCLUSIONS
  Bilateral thoracoscopic splanchnicectomy alleviated pain in patients with chronic pancreatitis. It was associated with a low morbidity rate and no deaths. Pain eventually recurred in approximately 50 per cent.
authors.affiliation: Department of Surgery, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: H C J L
authors.initials: HC
authors.lastname: Buscher
authors.forename: J B M J
authors.initials: JB
authors.lastname: Jansen
authors.forename: R
authors.initials: R
authors.lastname: van Dongen
authors.forename: R P
authors.initials: RP
authors.lastname: Bleichrodt
authors.forename: H
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D010149:Postoperative Pain / Q000517:prevention & control; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012008:Recurrence; D013153:Splanchnic Nerves / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*; D013997:Time Factors
chemical_list: D009294:Narcotics