title: Prospective evaluation of pain control and quality of life in patients with chronic pancreatitis following bilateral thoracoscopic splanchnicectomy.
abstract: BACKGROUND
  Abdominal pain in chronic pancreatitis (CP) is the most common symptom with a highly unfavorable impact on the quality of life. It has been shown that bilateral thoracoscopic splanchnicectomy (BTS) may produce marked pain relief for the majority of patients. The aim of this study was to evaluate the effectiveness of BTS in pain control and quality-of-life improvement in patients with a severe form of CP.
  
  
  METHODS
  Between April 2000 and April 2009, a total of 30 patients qualified for BTS due to CP-related pain. Their age ranged from 28 to 60 years. A 12-month follow-up period was planned for all the patients enrolled. To evaluate effectiveness of BTS, an 11-point Numeric Rating Scale (NRS) and the Quality of Life Questionnaire C-30 (QLQ-C30) in its basic form, developed by European Organization for Research and Treatment of Cancer, were used. An NRS value between 0 and 3 was considered a positive postoperative pain control result.
  
  
  RESULTS
  The bilateral splanchnicectomy procedure was performed successfully in 27 of 30 qualified patients. A positive effect based on decreased pain (p < 0.05) at 12 months was achieved in 24 patients (80 %). The initial change in quality of life was not significant but it gradually improved with time (preop vs. 12 months QLQ-C30 score, p < 0.001).
  
  
  CONCLUSIONS
  This study showed that BTS is safe and efficacious for pain alleviation in patients with severe CP. It may significantly increase the chances of a long-lasting, life-changing improvement in the quality of life.
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Ul. Czerniakowska 231, 00-416, Warsaw, Poland, lmilewski@post.pl.
authors.forename: Malgorzata B
authors.initials: MB
authors.lastname: Malec-Milewska
authors.forename: Wieslaw
authors.initials: W
authors.lastname: Tarnowski
authors.forename: Adam E
authors.initials: AE
authors.lastname: Ciesielski
authors.forename: Emilia
authors.initials: E
authors.lastname: Michalik
authors.forename: Maciej R
authors.initials: MR
authors.lastname: Guc
authors.forename: Jacek A
authors.initials: JA
authors.lastname: Jastrzebski
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D000328:Adult; D017763:Autonomic Denervation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010148:Intractable Pain / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D019512:Pancreatitis, Alcoholic / Q000523:psychology / Q000601:surgery; D050500:Pancreatitis, Chronic / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D013153:Splanchnic Nerves / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*