Bilateral Thoracoscopic Splanchnicectomy in the Management of Pain in Patients with Chronic Pancreatitis

In this chapter we demonstrates that five years after bilateral thoracoscopic splanchnicectomy, pain relief is obtained in about 40% of patients with chronic pancreatitis. Although these results are considerably less than those reported by other operative techniques, such as resection of an inflammatory mass in the head of the pancreas or pancreatic duct drainage according to Partington-Rochelle, bilateral thoracoscopic splanchnicectomy may have a place in the management of pain in patients with chronic pancreatitis for several reasons: First, the operative procedure is simple, has acceptable side effects and a very low mortality rate, especially when compared to the other operative techniques applied for pain relief in chronic pancreatitis. The procedure also requires considerably less operation time and hospital stay. Second, we have followed up our patients for a median time of five years, while most papers on operative techniques for pain relief in chronic pancreatitis reported shorter follow up, whereby success rates of other operative techniques may also drop. Third, bilateral thoracoscopic splanchnicectomy is applicable to chronic pancreatitis patients without an inflammatory mass or without a dilated pancreatic duct and so may be used in patients who do not have indications for more traditional pancreatic procedures.