Diagnosis and treatment of autoimmune pancreatitis in Spain

Aims: The analysis of laparoscopic operations in treatment of chronic pancreatitis. Patients & methods: In our clinic there were performed 32 laparoscopic interventions for chronic pancreatitis and its complications. Results: Laparoscopic interventions were performed in 32 cases: cystogastrostomy10, cystoduodenostomy2, cystojejunostomy3, cystectomy1, longitudinal laparoscopic pancreaticojejunostomy 2, the Beger procedure without proximal pancreatoenterostomy 2 and the Berne modification 10. In all the cases of laparoscopic procedures the communication of a cystwith the main pancreatic duct were confirmed by preoperative biochemical and cytologic analysis of cystic fluid taken under the ultrasound control puncture. By the patient with a cyst located in the tail of the pancreas, the bleeding from the splenic artery required to convert the operation. In another patient laparoscopic longitudinal pancreatovirsungotomy and pancreatic resection were performed due to the impossibility of adequate cyst drainage in the hamulus region of the pancreas which required conversion of the operation into open.Mean operating timewas 295(260-360). Blood loss was 105±59 ml. Postoperative hospital stay was 8 days. Conclusion: Clinical experience in the use of laparoscopic procedures in chronic pancreatitis treatment supports the conclusions of other authors concerning the advantages of laparoscopic techniques which are of better tolerance and which shorten hospital stay. The application of minimally invasive surgery techniques may be effective on condition that there is a thorough selection of patients taking into account the anatomic features of the pancreas and its duct system in every individual case.