ArticleArquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery2026
Videolaparoscopic pancreatojejunostomy using a hybrid technique in chronic pancreatitis without significant ductal dilatation.
Article in Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic pancreatitis without significant main duct dilation is difficult to treat, as classic drainage procedures are less effective. Endoscopic therapy is often limited by complex anatomy, multiple strictures, stones, and the need for repeated procedures, frequently providing incomplete pain relief. Surgery offers better long-term pain control, but small-duct disease requires alternative strategies.
aimsTo record the case of a 52-year-old man with alcoholic chronic pancreatitis who had progressive abdominal pain requiring opioids. Imaging showed a mildly dilated (6 mm), tortuous pancreatic duct with segmental strictures and a peripancreatic cystic lesion.
methodsEndoscopic treatment was considered suboptimal, and surgery was indicated. A hybrid laparoscopic pancreaticojejunostomy was performed, combining Izbicki's V-shaped parenchymal excision with a longitudinal Partington-Rochelle anastomosis. The goal was to achieve effective decompression despite the small duct diameter, while preserving a minimally invasive approach.
resultsRecovery was uneventful. Oral intake was resumed on the third postoperative day, and discharge occurred on the fifth. At six months, the patient had complete pain relief, a 20% reduction in insulin requirement, and improved control of exocrine insufficiency.
conclusionsThis hybrid laparoscopic technique is feasible and may be an effective alternative for patients with chronic pancreatitis and small-duct disease when standard procedures are unsuitable.
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