Background: Intractable pain is the most distressing symptom in patients suffering from unresectable pancreatic carcinoma and chronic pancreatitis and thoracoscopic splanchnicectomy is an emerging method in the past decade for pain control. Objectives: To evaluate the effectiveness and safety of thoracoscopic splanchnicectomy in controlling pain due to pancreatic diseases. Subjects and method: This descriptive, cross-sectional study was carried out between May 2004 and August 2006, on 29 patients with unresectable pancreatic carcinoma and chronic pancreatitis, treated by thoracoscopic splanchnicectomy. Their subjective pain was assessed by visual analogue scale (VAS). Intra- and post- operative complications and mortality, operative time and hospital length also so have been evaluated. Results: Among 29 patients, there were 21 cases of pancreatic carcinoma (11 males and 10 females) and 8 cases of chronic pancreatitis (100% were male). The average operative time was 133.27 \xb1 8.32 min (range 90-270 min). 27 cases (93.1%) underwent bilateral thoracoscopic splanchnicectomy and 2 cases (6.9%) underwent unilateral procedure. There was no death due to procedure. The mean hospital stay was 4.86 \xb1 0.56 days (range, 1\ufffd?3 days). Pain relief was most effective in the 1st week after operations. Conclusion: Thoracoscopic splanchnicectomy is a safe and effective procedure of treating malignant and benign intractable pancreatic pain. It is needed to study long-term efficacy of pain relief for chronic pancreatitis.
Pancreatic Diseases/ surgery ; Thoracoscopy ;

A 47-year-old female was admitted with progressive exertional dyspnea and diagnosed with anomalous drainage of the left pulmonary veins into the coronary sinus (CS), combined with an intact interatrial septum and a small patent ductus arteriosus (PDA). Multimodal imaging, including echocardiography, computed tomography, and cardiac catheterization, helps diagnosis, optimal management and monitoring. The patient successfully underwent surgical repair, which involved rerouting the left anomalous pulmonary veins into the left atrium through a surgically created atrial septal defect, while the CS continued to drain into the right atrium and the PDA was closed directly via a transpulmonary approach. The postoperative course was uneventful.