To the Editor.—We wish to reemphasize the value of splanchnicectomy in the relief of severe pain due to chronic pancreatitis.
Surgeons who performed sympathectomy for various indications observed that the operation was often followed by loss of visceral sensation. Mallet-Guy and Feroldi1,2 reported that left splanchnicectomy provided relief of the severe pain commonly associated with pancreatitis. Others reported similar relief of pancreatic pain after right splanchnicectomy or celiac ganglionectomy. Although unilateral denervation has often provided adequate relief of pain, bilateral procedures might be required in some patients.3,4
Results of experimental and clinical studies indicate that pancreatic pain is mediated through the splanchnic nerves, and that the vagus is not involved.5 Mallet-Guy and Feroldi2 believed that splanchnicectomy actually benefited the course of relapsing pancreatitis; however, this has not been confirmed. Splanchnicectomy must be viewed as a treatment directed entirely toward the relief of the severe pain that