TRANSHIATAL SPLANCHNICOTOMY FOR PAIN CONT ROL IN PANCREATIC-CANCER - RESULTS IN 51 OPERATED CASES

The greater splanchnic nerves are responsible for sympathetic innervat ion of the supra mesocolic viscera, and total bilateral neurotomy is e fficient to relieve pancreatic pain. Their dissection is easy by a mid line transperitoneal route used for pancreatic cancer surgery. The aim of this study was to evaluate the pain relief related to transhiatal bilateral splanchnicotomy in patients with pancreatic cancer. The tumo r was unresectable for all the patients, and nobody was operated only to make neurotomy. Twenty two patients had single bilateral splanchnic otomy, and other had an associated biliary and/or digestive diversion. There was nor postoperative specific mortality, and postoperative mor tality rate was 3,9 %. Specific postoperative morbidity rare was 6 %. Most of the patients (83,3 %) had immediate pain relief with or withou t diversion (respectively 80,7 % and 86,3 %, p = 0,6). Our data sugges t that pain recurs for same patients three months after surgery (pain control in respectively 69,2 % and 72,7 %), but difference was not sig nificant (p = 0,14). Our results demonstrate that transhiatal bilatera l splanchnicotomy relieves pain in patients with pancreatic cancer, wi th a pear specific morbidity.