Successful outcome of retrograde pancreatojejunostomy for chronic pancreatitis and infected pancreatic cysts: A case report

doi:10.12998/wjcc.v9.i24.7224

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Aug 26, 2021; 9(24): 7224-7230
Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7224

Successful outcome of retrograde pancreatojejunostomy for chronic pancreatitis and infected pancreatic cysts: A case report

Koichi Kimura, Eisuke Adachi, Ayako Toyohara, Sachie Omori, Kaoru Ezaki, Ryo Ihara, Takahiro Higashi, Kippei Ohgaki, Shuhei Ito, Shin-ichiro Maehara, Toshihiko Nakamura, Yoshihiko Maehara

Koichi Kimura, Eisuke Adachi, Ayako Toyohara, Sachie Omori, Takahiro Higashi, Kippei Ohgaki, Shuhei Ito, Shin-ichiro Maehara, Toshihiko Nakamura, Yoshihiko Maehara, Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan

Kaoru Ezaki, Ryo Ihara, Department of Internal Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan

Author contributions: Kimura K was responsible for the study conception, design and drafting of the manuscript; Toyohara A, Omori S, Ezaki K, Ihara R, Higashi T, Ohgaki K, Ito S, Maehara SI, and Nakamura T were responsible for data collection; Adachi E, and Maehara Y were responsible for critical revision of the manuscript; all authors issued final approval for the version to be submitted.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Koichi Kimura, MD, PhD, Doctor, Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, 3-23-1, Shiobaru, Minamiku, Fukuoka 815-8588, Japan. cubicseal@gmail.com

Received: April 6, 2021
Peer-review started: April 6, 2021
First decision: April 13, 2021
Revised: April 14, 2021
Accepted: July 14, 2021
Article in press: July 14, 2021
Published online: August 26, 2021
Processing time: 140 Days and 0.6 Hours

Abstract

BACKGROUND

Chronic pancreatitis occasionally requires surgical treatment that can be performed with various techniques. Often, this type of surgery presents with postoperative complications. We report a case of a successful retrograde pancreatojejunostomy for chronic pancreatitis and infected pancreatic cysts.

CASE SUMMARY

A 62-year-old male with a 10-year history of chronic pancreatitis presented with epigastric pain for one week and a 20 kg weight loss over one year. Computed tomography showed stones in the pancreas (mainly the head), expansion of the main pancreatic duct, and thinning of the pancreatic parenchyma. Magnetic resonance imaging showed infected pancreatic cysts connected to the stomach with a fistula from the splenic hilum to the caudal portion of the liver’s lateral segment. An endoscopic retrograde pancreatography was performed; the guide wires could not pass through the stones in the pancreas and therefore, drainage of the main pancreatic duct was not achieved. Next, a distal pancreatomy and splenectomy were performed; however, the pancreatic juice in the remaining parenchyma was blocked by the stones. Hence, we performed a retrograde pancreatojejunostomy and Roux-en-Y anastomosis. The patient had no postoperative complications and was discharged from the hospital on postoperative day 14.

CONCLUSION

A distal pancreatomy, retrograde pancreatojejunostomy, and Roux-en-Y anastomosis could be an effective surgical procedure for intractable chronic pancreatitis.

Keywords: Chronic pancreatitis; Infected pancreatic cyst; Distal pancreatomy; Retrograde pancreatojejunostomy; Pancreatic stones; Case report

Core Tip: Surgical treatment for chronic pancreatitis often presents with postoperative complications. We present the case of a successful retrograde pancreatojejunostomy for chronic pancreatitis and infected pancreatic cysts. This surgical procedure might be a valid option for surgeons faced with similar cases.