Ductal drainage with head coring in chronic pancreatitis with small-duct disease.
OBJECTIVE
To assess prospectively the feasibility of drainage procedures in patients with chronic pancreatitis and small ducts.


METHODS
Forty-five patients with chronic pancreatitis and main pancreatic ductal diameters less than 5 mm (group 1) underwent lateral pancreaticojejunostomy with varying degrees of head coring. Their outcomes were recorded and compared with 212 patients who had large ducts (diameter >7 mm; group 2). Patients in the two groups were comparable in age, etiology, presence of jaundice, diabetes, steatorrhea, head mass, pseudocysts, and biliary obstruction.


RESULTS
Mortality and complication rates were similar in the two groups. Drainage procedures relieved pain in 94% (43/45 cases) in small-duct disease, and 91% (193/212) of cases with large-duct disease over a median follow-up greater than 30 months. Functional results were also comparable.


CONCLUSIONS
In the light of these results, drainage procedures merit wider application for small-duct disease.
Department of GI Surgery, PVS Memorial Hospital, Cochin, India.
Hariharan
H
Ramesh
George
G
Jacob
Vijayalakshmi
V
Lekha
Ambadi
A
Venugopal
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004322:Drainage / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000503:physiopathology / Q000601:surgery*; D010193:Pancreaticojejunostomy / Q000379:methods*; D010195:Pancreatitis / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies