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This compendium of reviews in gastrointestinal surgery covers topics that are of
contemporary interest to surgeons refecting the popular trends in this feld. Started
by the Indian Association of Surgical Gastroenterology (IASG), the GI Surgery
Annual has covered a journey of over 2 decades which speaks for its relevance and
popularity among general and gastrointestinal surgeons. The reviews contain up-to-
date scientifc content of enduring academic interest with each new volume covering
10-12 topics. From 2016 onwards, this Annual turns a new page in its academic
journey by publishing the forthcoming titles with Springer. The editorial control
continues to remain with the IASG and the current editorial board.
The idea of GI Surgery Annual was frst conceived during the annual conference
of Indian Association of Surgical Gastroenterology in 1991 and the First Volume
came into existence in the year 1994, through the efforts of Professor TK
Chattopadhyay and his team of co-editors. Professor TK Chattopadhyay continues
to head the editorial board in his current capacity as Professor Emeritus, AIIMS,
New Delhi.
This Annual is an essential resource for postgraduate and postdoctoral trainees in
surgery and gastrointestinal surgery, for practising surgeons who wish to keep
up-to-date with developments in the feld and for established academic surgeons
as well.
contemporary interest to surgeons refecting the popular trends in this feld. Started
by the Indian Association of Surgical Gastroenterology (IASG), the GI Surgery
Annual has covered a journey of over 2 decades which speaks for its relevance and
popularity among general and gastrointestinal surgeons. The reviews contain up-to-
date scientifc content of enduring academic interest with each new volume covering
10-12 topics. From 2016 onwards, this Annual turns a new page in its academic
journey by publishing the forthcoming titles with Springer. The editorial control
continues to remain with the IASG and the current editorial board.
The idea of GI Surgery Annual was frst conceived during the annual conference
of Indian Association of Surgical Gastroenterology in 1991 and the First Volume
came into existence in the year 1994, through the efforts of Professor TK
Chattopadhyay and his team of co-editors. Professor TK Chattopadhyay continues
to head the editorial board in his current capacity as Professor Emeritus, AIIMS,
New Delhi.
This Annual is an essential resource for postgraduate and postdoctoral trainees in
surgery and gastrointestinal surgery, for practising surgeons who wish to keep
up-to-date with developments in the feld and for established academic surgeons
as well.
Introduction
Chronic pancreatitis (CP) is an often painful and debilitating disorder that remains
a challenge for both patients and physicians. It is a rare disorder, with an estimated
incidence of 0.2%–0.6% in the USA [1, 2]. Despite its rarity, the economic impact
of CP is substantial, with total estimated annual healthcare expenditure of US$ 2.6
billion [3]. Frequent hospital admissions, emergency department visits and lost days
of work become a tiresome and expensive way of life for patients with recurrent or
constant pain due to CP. Additionally, if left untreated, many patients will develop
exocrine and endocrine insuffciency, and some will go on to develop pancreatic
cancer [4, 5].
The goal of treating CP is to reduce pain and restore quality of life. Initial inter-
ventions are aimed at correcting the mechanical, metabolic, immunological or phar-
macological causes of the disease. Medical options can include antioxidants,
pancreatic enzymes (which both reduce pancreatic stimulation and treat pancreatic
exocrine insuffciency), narcotic analgesics and nerve block procedures [6, 7].
Endoscopic interventions may include stone extraction, sphincterotomy, stricture
dilation and stent placement [6, 8]. If medical or endoscopic treatments are not suc-
cessful, patients may be candidates for surgery.
Surgical techniques include partial pancreatic resection (Whipple or distal pan-
createctomy) and drainage procedures such as lateral pancreaticojejunostomy
(Puestow) and variants (Frey, Beger). Patients often have transient pain relief, but
due to the diffuse and progressive nature of CP, pain eventually recurs in up to 50%
a challenge for both patients and physicians. It is a rare disorder, with an estimated
incidence of 0.2%–0.6% in the USA [1, 2]. Despite its rarity, the economic impact
of CP is substantial, with total estimated annual healthcare expenditure of US$ 2.6
billion [3]. Frequent hospital admissions, emergency department visits and lost days
of work become a tiresome and expensive way of life for patients with recurrent or
constant pain due to CP. Additionally, if left untreated, many patients will develop
exocrine and endocrine insuffciency, and some will go on to develop pancreatic
cancer [4, 5].
The goal of treating CP is to reduce pain and restore quality of life. Initial inter-
ventions are aimed at correcting the mechanical, metabolic, immunological or phar-
macological causes of the disease. Medical options can include antioxidants,
pancreatic enzymes (which both reduce pancreatic stimulation and treat pancreatic
exocrine insuffciency), narcotic analgesics and nerve block procedures [6, 7].
Endoscopic interventions may include stone extraction, sphincterotomy, stricture
dilation and stent placement [6, 8]. If medical or endoscopic treatments are not suc-
cessful, patients may be candidates for surgery.
Surgical techniques include partial pancreatic resection (Whipple or distal pan-
createctomy) and drainage procedures such as lateral pancreaticojejunostomy
(Puestow) and variants (Frey, Beger). Patients often have transient pain relief, but
due to the diffuse and progressive nature of CP, pain eventually recurs in up to 50%
of patients [9, 10]. Furthermore, patients frequently continue to develop exocrine
and endocrine insuffciency despite surgery [11–14].
and endocrine insuffciency despite surgery [11–14].
