A Male patient with a history of alcohol addiction present with history of pancreatitis. Evaluation reveals multiple stones in the tail of the pancreas. Which of the following is a more appropriate management?
|A||Remove tail of pancreas|
|C||Percutaneous removal of stone|
a. Therapy for patients with chronic pancreatitis is directed toward two major problems – pain and maldigestion.
b. Patient with intermittent attacks of pain are treated essentially like those with acute pancreatitis.
c. Patients with severe and persistent pain should avoid Alcohol completely and avoid large meals rich in fat.
d. ERCP allows the surgeon to plan the operative approach. If there is a stricture of the pancreatic duct, a local resection may ameliorate the pain.
e. In most patients with alcohol-induced disease, the pancreas is diffusely involved, and surgically correctible localized ductal disease1 is rare.
f. When there is primary ductal obstruction and dilation, ductal decompression may provide effective pain palliation
g. Endoscopic treatment of chronic pancreatitis may involve sphincterotomy of the minor or major pancreatic sphincter, dilatation of strictures, removal of calculi, or setting of the ventral or dorsal pancreatic duct.
h. Surgical treatment of chronic pancreatitis can be broadly categorized into three groups: ampullary procedures, ductal drainage procedures, and ablative procedures.
i. Ductal Drainage Procedures. A ductal drainage procedure intended to decompress the pancreatic duct in a retrograde manner.
j. This procedure involved a limited distal pancreatectomy and an endto end pancreaticojejunostomy.
k. The side-to side pancreaticojejunostomy. This procedure is now more widely used than the caudal pancreaticojejunostomy, and it has been evaluated in many large clinical series with success rates of 60 to 90%.