The following was an assessment that I do not share completely today: I agree with the sceptics that there is every reason to avoid over-enthusiastic surgery for chronic pancreatitis. I am very conservative with these patients and advise surgery when pain-killing celiac ganglion blocks, enzyme supplements, etc. fail abjectly.
Anyways, here is what I had to claim in 2004-2005:
Laparoscopic pancreatic surgery has usually been restricted to
staging for malignancy,internal drainage of pseudocysts and
However, the more complex procedures for chronic pancreatitis
and cancer of the head of pancreas are also worth considering.
Laparoscopic Whipple’s operation, while affording spectacular
views and being a great exercise in laparoscopic skills, is
unlikely to become popular in the near future, owing to its
complexity and the lack of evidence regarding its benefits.
Laparoscopic palliation for cancer of the head of pancreas is
technically less difficult. 16 bypass procedures have been done
without any major complications.
Laparoscopic surgery for chronic pancreatitis is another niche
area where there is very little world literature.
Of the drainage procedures for chronic pancreatitis, laparoscopic
pancreaticojejunostomy is more classical but more tedious.
The newer procedure of lap pancreaticogastrostomy is
superior because of its near-zero leak rate, ease and simplicity of
the technique, and efficacy. In our developing series of cases, we
have not had any leak or complication with the procedure.
It is likely that in the near future, lap pancreaticogastrostomy will
be the procedure of choice for the disease.
Department of Minimally Invasive Surgery