Authors:

Abstract

Chronic pancreatitis may cause disabling pain unresponsive to oral analgesics and/or drainage procedures. Radiological guided coeliac plexus ablation is beneficial, although it is only a temporary method for pain relief. Bilateral splanchnicectomy provides a more permanent pain relief method with minimum morbidity if performed by thoracoscopy. The results of twenty one thoracoscopic splanchnicectomies performed at the university surgical unit, Peradeniya, Sri Lanka from January 2011 to June 2015 were analysed to evaluate the surgical technique and to quantify the efficacy of pain relief. All had an acceptable operating time, no measurable blood loss, no conversions to open surgery, no intercostal drainage, early mobilization and feeding. All had an average pain score of 8-10 pre-operatively. This was reduced to 1 or no pain on post-operative day one in all patients. Eighteen patients out of 21 (86%) remained pain free
during follow up; follow up ranged from one month to forty eight months.
Bilateral thoracoscopic splanchnicectomy is safe and provides effective relief of chronic agonizing pancreatic pain.

Keywords: Thoracoscopy,  splanchnicectomy,  chronic pancreatic pain