Comparative analysis of treatment outcomes in chronic pancreatitis complicated by pancreatolithiasis

To evaluate the outcomes of a modified Puestow-type pancreaticojejunostomy in patients with chronic pancreatitis complicated by pancreatolithiasis. The study included 32 patients who underwent surgical treatment for pancreatolithiasis. The main group consisted of 20 patients who received the authors' modification of the anastomosis, while the comparison group included 12 patients treated using the standard technique. Parameters assessed included operation duration, mechanical ventilation time, length of hospital stay, complication rates, and recurrence rates. Statistical analysis involved the t-test, χ² test, and Kaplan-Meier survival analysis. The results showed showed a significant reduction in operation time (113.5±6.8 vs. 134.4±5.7 minutes; p=0.025), mechanical ventilation duration (3.0±0.3 vs. 4.25±0.5 hours; p=0.04), and hospital stay (6.3±0.5 vs. 8.4±0.8 days; p=0.033) in the main group. Postoperative complications occurred less frequently, and no reinterventions were required. The recurrence rate of stone formation was reduced from 33.3% in the comparison group to 5.0% in the main group (p=0.033), with cumulative recurrence-free survival of 91.7% versus 78.3%. The modified pancreaticojejunostomy technique provides superior surgical and clinical outcomes in pancreatolithiasis, significantly reducing the risk of recurrence and complications. The study recommended that the modified technique should be considered the preferred surgical option for patients with chronic pancreatitis and pancreatolithiasis.