Gastric acidity following longitudinal pancreaticogastrostomy.

BACKGROUND/AIMS: The main aim of this study was to investigate whether pancreatic juice released into the stomach during longitudinal pancreaticogastrostomy and pancreatico-cysto-gastrostomy have an effect on gastric acidity.

METHODOLOGY

We selected twenty-nine patients with chronic pancreatitis of whom 22 underwent longitudinal pancreaticogastrostomy and 7 pancreatico-cysto-gastrostomy due to painful chronic pancreatitis. Twenty-four hour gastric monitoring was carried out for every patient before and 6 weeks after the operation. Early and late results were evaluated.

RESULTS

Following postoperative check-up we found that intervention had resulted in effective pain relief in 83% of patients. The median pain scores were reduced from 120 (range 30-220) to 40 (range 10-190). Patients had no digestive problems from pancreatic enzyme substitution. There were no postoperative deaths. Statistical evaluation of the 24-hour gastric pH monitoring before and after the operation showed no alteration in gastric pH levels.

CONCLUSIONS

These results show that intractable pain can be relieved by pancreaticogastrostomy. We consider pancreaticogastrostomy as the operation of choice for the relief of intolerable pain in selected patients with chronic pancreatitis associated with pancreatic duct dilatation.