Affiliation:
1. Department of Gastroenterology, Deva Matha Hospital, Koothattukulam 686 662, Kerala, India
Abstract
Abstract
Over a 7-year period, 91 patients with tropical pancreatitis underwent operation for intractable pain. Univariate and multivariate analyses were performed to identify factors correlating with mortality, major complications, poor pain relief and associated malignancy. Patients with benign disease (group 1, n = 72) had longer survival than those with superimposed malignancy (group 2, n = 19). Pain relief was better in group 1 (59 patients compared with none, P < 0.01). Age above 40 years, short duration of symptoms, mass lesions on ultrasonography and main pancreatic duct obstruction on endoscopic retrograde pancreatography were associated with a high risk of cancer. After reoperation major complications (four of ten) or death (three of ten) occurred more commonly than after primary procedures (seven of 81, P = 0.019 and five of 81, P < 0.05, respectively). Poor pain relief in group I patients was more common after incomplete clearance of main duct stones (four of 13 versus three of 53, P < 0.01) and after short length ductotomy (three of eight versus four of 58, P < 0.01). Tropical pancreatitis has a high association with pancreatic adenocarcinoma. Wide ductotomy, stone clearance and drainage gave good symptomatic results in patients with benign disease. Overall results were poor in patients with cancer.
Funder
Medical Research Society of the Deva Matha Hospital, Ooothattukulam, Kerala, India
Publisher
Oxford University Press (OUP)
Cited by
20 articles.
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