Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis
Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis
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DOI：
10.1046/j.1365-2168.2002.01988.x
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发表时间：
2002-02-01
影响因子：
9.6
通讯作者：
van Goor, H
中科院分区：
文献类型：
--
作者：
Buscher, HCJL;Jansen, JBMJ;van Goor, H
背景：慢性胰腺炎患者的疼痛管理是困难的。本前瞻性研究的目的是评估早期和长期的疼痛缓解提供双侧胸腔镜内脏nicectomy.Methods：从1995年8月至1999年8月，44例慢性胰腺炎患者接受双侧胸腔镜内脏nicectomy。前瞻性收集数据。36名患者需要阿片类药物。术前和术后定期采用视觉模拟评分法（VAS）记录疼痛强度。使用止痛剂（阿片类药物;非甾体类抗炎药和对乙酰氨基酚;无镇痛药或对乙酰氨基酚）。中位随访时间为36（范围12-60）months.Results：40例患者的手术在技术上是成功的。36例患者无并发症。随访24个月或更长时间的24例患者中有11例在2年时VAS评分显著降低（中位数（范围）8.5（7-10）vs 2.5（0-5）; P < 0.01）。疼痛缓解的累积率为46%，48个月后内脏nicectomy.Conclusion：双侧胸腔镜内脏切除术减轻慢性胰腺炎患者的疼痛。它与低发病率和无死亡有关。大约50%的患者最终再次出现疼痛。
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.Conclusion: 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.