MTP5.02 Laparoscopic Mini-Pancreatojejunostomy Combined with Endoscopic-guided Laser Lithotripsy in the Treatment of Chronic Pancreatitis: A Prospective Case Series

Introduction Chronic pancreatitis frequently requires surgical management when conservative treatments fail or there is suspicion of neoplastic lesions. Pancreatic ductal calculi complicate the disease course, often necessitating more advanced treatment strategies. Recent innovations, such as combining laparoscopic surgery with endoscopic-guided laser lithotripsy, offer new possibilities in managing these cases with potentially less invasiveness. Methods A prospective case series was conducted on five patients diagnosed with chronic pancreatitis, who underwent the laparo-endoscopic procedure between 08/2023 and 03/2024. Parameters assessed included operative time, blood loss, hospital stay, and postoperative outcomes, including pain relief and resumption of normal activities. Results The cohort consisted of five patients with a mean age of 38 years, four of whom had a history of alcohol and/or tobacco use, and two presented with pancreatic pseudocysts. The average operative time was 165 minutes, with a mean blood loss of 75mL. Patients were discharged after a mean hospital stay of 9 days. No postoperative complications or reoperations were reported. Follow-up at 1, 3, and 6 months showed no recurrence of abdominal pain, and imaging confirmed the absence of pancreatic stones. All patients experienced significant pain relief and returned to normal activities within the follow-up period. Conclusion The combined laparoscopic pancreatojejunostomy and endoscopic-guided laser lithotripsy approach demonstrates a high degree of safety, feasibility, and effectiveness in the management of chronic pancreatitis. This approach may reduce residual stone rates and shorten pancreatojejunostomy lengths, improving patient outcomes. Further large-scale studies are required to validate these findings and assess long-term benefits.