Surgical Approaches Review for Chronic Pancreatitis: A Comprehensive Review

• Autor(a) principal: De Castro Monteiro, Rafaela Valéria
• Data de Publicação: 2023
• Outros Autores: Fock Tasca , Anna Carolina, Mara Magalhães , Lívia, Saldanha Peçanha , Anna Luiza, Rose Martins, Fabiana
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Brazilian Journal of Implantology and Health Sciences
• Texto Completo: https://bjihs.emnuvens.com.br/bjihs/article/view/1011
• topic: Pancreatite; Abordagens Cirúrgicas; Revisão Abrangente.; Pancreatitis; Surgical Approaches; Comprehensive Review.

The surgical approach to chronic pancreatitis reveals a diverse range of strategies, each with its own merits and considerations. Total Pancreatectomy with Islet Autotransplantation (TPIAT) emerges as a promising option, aiming to provide effective pain relief and enhance the quality of life, especially in the early stages of the disease. The need for a careful multidisciplinary assessment is emphasized, involving specialists in pancreatology, surgery, endocrinology, pain management, and social assistance. Various surgical procedures, such as the combination of drainage and resection, demonstrate efficacy in pain relief in specific cases, while early surgery, including minimally invasive approaches, stands out in the long-term control of chronic pancreatitis. However, technical challenges persist, and innovative surgical strategies, such as the use of robotic platforms, are being explored to improve outcomes. The comparative analysis between endoscopic and surgical interventions underscores the superiority of the latter, particularly the hybrid approach, in pain relief. The safety and efficacy of laparoscopic approaches, coupled with specific techniques like Frey's, highlight the crucial role of innovative surgery in managing chronic pancreatitis. The choice between surgical and endoscopic approaches requires careful evaluation, considering the patient's clinical response, specific pancreatic anatomy, and the availability of technical resources. Furthermore, the importance of preoperative, intraoperative, and postoperative considerations stands out in the literature, significantly influencing outcomes. Strategies to optimize long-term results, such as insulin administration and pancreatic enzyme therapy, are essential. In summary, the surgical approach to chronic pancreatitis is a dynamic area of research, continually seeking to enhance techniques and strategies to improve the quality of life for patients.