Lateral Pancreatojejunostomy and Lateral Pancreaticogastrostomy in the Management of Calcific Pancreatitis: A Comparative Study

Background: Calcific pancreatitis in pediatric patients poses significant management challenges, with surgical intervention often required for symptomatic relief. Lateral pancreatojejunostomy (LPJ) and lateral pancreaticogastrostomy (LPG) are two established drainage procedures, but comparative studies in children remain limited. This study aims to evaluate the efficacy and outcomes of LPJ versus LPG in pediatric patients with calcific pancreatitis. Methods: A comparative study was conducted at National Gastroliver Institute & Hospital, Dhaka and Dhaka Medical Collage Hospital (DMCH) Bangladesh from January 2022 to December 2023, involving 26 patients aged ≤13 years, purposively selected and randomly allocated into two groups: LPJ (n=13) and LPG (n=13). Clinical outcomes, including pain relief, postoperative complications, hospital stay, and recurrence rates, were analyzed using SPSS version 23.0 Results: Both LPJ and LPG demonstrated effective pain relief in pediatric calcific pancreatitis, with comparable postoperative VAS scores (LPJ: 1.5±0.6 vs LPG: 1.4±0.5, p=0.682). LPG showed fewer complications (15.4% vs 30.8%, p=0.042), particularly reduced wound infections (7.7% vs 23.1%). Operative times (142±18 vs 158±22 minutes, p=0.082) and hospital stays (7.2±1.5 vs 6.8±1.3 days, p=0.124) were similar. Recurrence rates at 12 months were identical (7.7% each). Conclusion: Both LPJ and LPG effectively managed pediatric calcific pancreatitis, with comparable pain relief and recurrence rates. LPG demonstrated a superior safety profile with fewer postoperative complications, suggesting its potential as a preferred surgical option in this patient population.