Introducere: Splanchnicectomia toracoscopica(ST) este utilizata pentru tratamentul sindroamelor algice abdominale superioare ca
alternativa la blocul plexului celiac pentru pancreatita cronicarecidfivanta (PCR) sau neoplasme maligne supramesocolice, incluzand
cancer pancreatic inoperabil (CPI).
Material si metode: Studiul include 57(66,27%) pacienti cu PCR si 24(27,9%) pacienti cu CPI, 5(5,81%) pacienti cu cancer cu
localizare nepancreatica nerezecabil, desfasurat in perioada anilor 2008-2017 in cadrul Catedrei 2 Chirurgie. Lotul de pacienti cu PCR
a inclus 50(87,72%) barbati si 7(12,28%) femei, varsta medie - 52,0 ani (limitele 28-72ani). Lotul de pacienti cu CPI -22(91,67%)
barbati, 2(8,33%) femei, varsta medie - 58ani (limitele 45-78 ani).
Scop. Evaluarea rolului ST in tratamentul sindromului de durere in PCR si CPI.
Rezultate: S-au practicat 68(79,07%) ST pe stanga, 13(15,12%) ST pe dreapta (5(5,8%) pacienti, au necesitat si ST dreapta la 2 luni
dupa ST stanga, datorita raspunsului terapeutic minimal). Efectul analgetic pe termen scurt (<3 luni) este denotat de eficacitatea in
57(100%) cazuri de PCR si 20(83,3%) cazuri de CPI. Intre 3-6 luni eficacitatea analgeziei s-a mentinut la 39(68,42%) cazuri de PCR
(continuand ulterior dupa 6 luni) si 15(62,5%) cazuri de CPI. Mortalitatea perioperatorie-0. Spitalizarea medie postoperatorie a fost
de 3,3 zile (2-5 zile).
Concluzii: Splanchnicectomia toracoscopica prezinta avantaje multiple pentru pacient in special in diminuarea sindromului algic,
lipsa de complicatii si implicit costuri mai mici in controlul durerii din CPI si PCR refractara la tratamentul antalgic conservator.

Introduction: Thoracoscopic splanchnicectomy (TS) has been used for the management of upper abdominal pain syndromes as
an alternative to celiac plexus block for chronic relapsing pancreatitis (CRP) or supramesocolic malignant neoplasms, including
unresectable pancreatic cancer (UPC).
Material and metode: The study includes 57(66,27%) patients with CRP and 24(27,9%) patients with UPC, 5(5,81%) patients with
extrapancreatic unresectable cancer, held during the years 2008-2017. The patients with CRP included 50(87,72%) men and
7(12,28%) women, the average age - 52,0 years (28-72 years). The patients with UPC -22(91,67%) men and 2(8,33%) women,
average age - 58 years (within 45-78 years).
Purpose: The rating of TS in the treatment of pain syndrome in relapsing CRP and UPC.
Results: They practiced 68(79,07%) TS on the left 13(15,12%) TS on the right, (5(5,8%) patients also required TS on the right
on 8 weeks after TS on the left due tot he minimal therapeutic response). The analgesic effect on short-term (<3 months) had an
efficacy in 57(100%)relapsing CRP cases and 20(83,3%) cases of UPC. Between 3-6 months, the analgesia efficacy was maintained
at 39(68,42%) cases of CRP (continuing after 6 months) and 15(62,5%) cases ofUPC, 15(62,5%) cases of UPC (after 6 months).
The perioperative mortality was 0 . Mean postoperative hospital stay was 3,3 days (2-5 days).
Conclusion: Thoracoscopic splanchnicectomy presents the advantages of the minimally invasive approach, especially in the absence
of complications, lower costs in UPC and CRP pain control during the conservative analgesic treatment.