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 pancre aticogastrostomy and pancreatico-cysto-gastrostomy have an effect on g astric acidity. METHODOLOGY: We selected twenty-nine patients with chr onic pancreatitis of whom 22 underwent longitudinal pancreaticogastros tomy and 7 pancreatico-cysto-gastrostomy due to painful chronic pancre atitis. 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 th at intervention had resulted in effective pain relief in 83% of patien ts. The median pain scores were reduced from 120 (range 30-220) to 40 (range 10-190). Patients had no digestive problems from pancreatic enz yme substitution. There were no postoperative deaths. Statistical eval uation of the 24-hour gastric pH monitoring before and after the opera tion showed no alteration in gastric pH levels. CONCLUSIONS: These res ults show that intractable pain can be relieved by pancreaticogastrost omy. We consider pancreaticogastrostomy as the operation of choice for the relief of intolerable pain in selected patients with chronic panc reatitis associated with pancreatic duct dilatation.