Comparison of Clinical Effect of Surgical Treatment for Chronic Pancreatic Head Mass Pancreatitis Combined with Pancreatic Ductal Stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGGuang-quan , LILe , CHENHua , BAIXue-wei , WANGGang , KONGRui , TANHong-tao ,  SUNBei

Department of Biliary and Pancreatic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China;

Corresponding author：

SUNBei, Email: sunbei70@tom.com

Keywords：

Chronic pancreatitis; Pancreatic ductal stones; Beger procedure; Frey procedure

DOI：

10.7507/1007-9424.20160177

Video：

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Objective To compare the surgical outcome of surgical treatment for chronic pancreatic head mass pancreatitis combined with pancreatic duct stones. Methods Clinical data of 19 patients diagnosed as chronic pancreatic head mass pancreatitis combined with pancreatic duct stones by pathology in our hospital were analyzed retrospectively and patients were divided into Beger group (n=9) and Frey group (n=10) according to operation type. Results The duration of operation, blood loss, morbidity, ratio of postoperative pancreatic fistula of grade B, ratio of abdominal cavity infection, ratio of gastric emptying dysfunction, total length of hospital stay, and total hospitalization cost in Frey group were less or lower than those in Beger group significantly (P ＜0.05). None of death or pancreatic fistula of grade C happened in both 2 groups, and abdominal pain and jaundice were subsided in all patients. There were 18 patients (94.7%) were followed up for (8.6±2.5) years ( 5-12 years), and just 1 patient of Frey group was not available for followup. The ratios of 5-year pain subsided of 2 groups were both 7/9, there was no significant difference between the 2 groups (P>0.05). During the follow-up period, there was no dead, relapsed, cancerate or reoperation, but 2 patients suffered from diabetes (1 patient of Frey group and 1 patient of Beger group), 2 patients suffered from steatorrhea (1 patient of Frey group and 1 patient of Beger group), and there was no significant difference between the 2 groups in the ratios of diabetes and steatorrhea (P>0.05). Conclusion The effect is equal for Frey surgery and Beger surgery in treatment of chronic pancreatic head mass pancreatitis combined with pancreatic duct stones, but recover of patient who receives Frey surgery is better than that of Beger surgery.

Citation： ZHANGGuang-quan, LILe, CHENHua, BAIXue-wei, WANGGang, KONGRui, TANHong-tao, SUNBei. Comparison of Clinical Effect of Surgical Treatment for Chronic Pancreatic Head Mass Pancreatitis Combined with Pancreatic Ductal Stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 658-662. doi: 10.7507/1007-9424.20160177 Copy

1.	施长鹰, 吴志勇. 慢性胰腺炎诊断与外科治疗. 中国实用外科杂志, 2009, 29(8): 686-689.
2.	Fang WL, Shyr YM, Su CH, et al. Long-term follow-up study of surgical treatment for pancreatic stones. Hepatogastroenterology, 2007, 54(73): 246-249.
3.	Mariani A, Bernard JP, Provansal-Cheylan M, et al. Differences of pancreatic stone morphology and content in patients with pancreatic lithiasis. Dig Dis Sci, 1991, 36(11): 1509-1516.
4.	Pakosz-Golanowska M, Post M, Lubikowski J, et al. Partingtonrochelle pancreaticojejunostomy for chronic pancreatitis: analysis of outcome including quality of life. Hepatogastroenterology, 2009, 56(94-95): 1533-1537.
5.	Isaji S. Has the partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence. J Hepatobiliary Pancreat Sci, 2010, 17(6): 763-769.
6.	冀亮, 孙备. 慢性胰腺炎外科治疗的研究进展. 中华胰腺病杂志, 2013, 13(5): 354-357.
7.	Talamini G, Bassi C, Falconi M, et al. Early detection of pancreatic cancer following the diagnosis of chronic pancreatitis. Digestion, 1999, 60(6): 554-561.
8.	孙备, 陈友谊. 慢性胰腺炎疼痛的发生机制及处理对策. 中国实用外科杂志, 2011, 31(9): 806-808.
9.	Braganza JM, Lee SH, McCloy RF, et al. Chronic pancreatitis. Lancet, 2011, 377(9772): 1184-1197.
10.	中华医学会外科学分会胰腺外科学组. 慢性胰腺炎诊治指南 (2014). 中华外科杂志, 2015, 53(4): 241-246.
11.	Bachmann K, Kutup A, Mann O, et al. Surgical treatment in chronic pancreatitis timing and type of procedure. Best Pract Res Clin Gastroenterol, 2010, 24(3): 299-310.
12.	Frey CF, Amikura K. Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy in the management of patients with chronic pancreatitis. Ann Surg, 1994, 220(4): 492-507.
13.	Ha PH. Results of treatment for chronic pancreatitis by the combined Frey and Beger procedure. J Visc Surg, 2015, 152(2): 93-97.
14.	Cahen DL, Gouma DJ, Laramee P, et al. Long-term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis. Gastroenterology, 2011, 141(5): 1690-1695.
15.	Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med, 2007, 356(7): 676-684.
16.	Díte P, Ruzicka M, Zboril V, et al. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy, 2003, 35(7): 553-558.
17.	Partington PF, Rochelle RE. Modified puestow procedure for retrograde drainage of the pancreatic duct. Ann Surg, 1960, 152(6): 1037- 1043.
18.	Ihse I, Andersson R, Lindell G. Is there still an indication for pancreatic duct drainage in chronic pancreatitis?. Ann Ital Chir, 2000, 71 (1): 39-42.
19.	Beger HG, Büchler M, Bittner R. The duodenum preserving resection of the head of the pancreas (DPRHP) in patients with chronic pancreatitis and an inflammatory mass in the head. An alternative surgical technique to the Whipple operation. Acta Chir Scand, 1990, 156(4): 309-315.
20.	Beger HG, Büchler M. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis with inflammatory mass in the head. World J Surg, 1990, 14(1): 83-87.
21.	Strate T, Taherpour Z, Bloechle C, et al. Long-term follow-up of a randomized trial comparing the Beger and Frey procedures for patients suffering from chronic pancreatitis. Ann Surg, 2005, 241(4): 591-598.
22.	Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas, 1987, 2(6): 701-707.
23.	杨尹默, 马永蔌, 高红桥, 等. 慢性胰腺炎的外科治疗及术式评价. 中国实用外科杂志, 2011, 31(9): 788-791.
24.	Hong J, Wang J, Keleman AM, et al. Endoscopic versus surgical treatment of downstream pancreatic duct stones in chronic pancreatitis. Am Surg, 2011, 77(11): 1531-1538.
25.	Rieder S, Michalski CW, Friess H. Indications for endoscopic or surgical treatment of chronic pancreatitis. Dig Dis, 2010, 28(2): 344-349.
26.	Jalleh RP, Willamson RC. Pancreatic exocrine and endocrine function after operations for chronic pancreatitis. Ann Surg, 1992, 216(6): 656-662.

1. 施长鹰, 吴志勇. 慢性胰腺炎诊断与外科治疗. 中国实用外科杂志, 2009, 29(8): 686-689.
2. Fang WL, Shyr YM, Su CH, et al. Long-term follow-up study of surgical treatment for pancreatic stones. Hepatogastroenterology, 2007, 54(73): 246-249.
3. Mariani A, Bernard JP, Provansal-Cheylan M, et al. Differences of pancreatic stone morphology and content in patients with pancreatic lithiasis. Dig Dis Sci, 1991, 36(11): 1509-1516.
4. Pakosz-Golanowska M, Post M, Lubikowski J, et al. Partingtonrochelle pancreaticojejunostomy for chronic pancreatitis: analysis of outcome including quality of life. Hepatogastroenterology, 2009, 56(94-95): 1533-1537.
5. Isaji S. Has the partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence. J Hepatobiliary Pancreat Sci, 2010, 17(6): 763-769.
6. 冀亮, 孙备. 慢性胰腺炎外科治疗的研究进展. 中华胰腺病杂志, 2013, 13(5): 354-357.
7. Talamini G, Bassi C, Falconi M, et al. Early detection of pancreatic cancer following the diagnosis of chronic pancreatitis. Digestion, 1999, 60(6): 554-561.
8. 孙备, 陈友谊. 慢性胰腺炎疼痛的发生机制及处理对策. 中国实用外科杂志, 2011, 31(9): 806-808.
9. Braganza JM, Lee SH, McCloy RF, et al. Chronic pancreatitis. Lancet, 2011, 377(9772): 1184-1197.
10. 中华医学会外科学分会胰腺外科学组. 慢性胰腺炎诊治指南 (2014). 中华外科杂志, 2015, 53(4): 241-246.
11. Bachmann K, Kutup A, Mann O, et al. Surgical treatment in chronic pancreatitis timing and type of procedure. Best Pract Res Clin Gastroenterol, 2010, 24(3): 299-310.
12. Frey CF, Amikura K. Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy in the management of patients with chronic pancreatitis. Ann Surg, 1994, 220(4): 492-507.
13. Ha PH. Results of treatment for chronic pancreatitis by the combined Frey and Beger procedure. J Visc Surg, 2015, 152(2): 93-97.
14. Cahen DL, Gouma DJ, Laramee P, et al. Long-term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis. Gastroenterology, 2011, 141(5): 1690-1695.
15. Cahen DL, Gouma DJ, Nio Y, et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med, 2007, 356(7): 676-684.
16. Díte P, Ruzicka M, Zboril V, et al. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy, 2003, 35(7): 553-558.
17. Partington PF, Rochelle RE. Modified puestow procedure for retrograde drainage of the pancreatic duct. Ann Surg, 1960, 152(6): 1037- 1043.
18. Ihse I, Andersson R, Lindell G. Is there still an indication for pancreatic duct drainage in chronic pancreatitis?. Ann Ital Chir, 2000, 71 (1): 39-42.
19. Beger HG, Büchler M, Bittner R. The duodenum preserving resection of the head of the pancreas (DPRHP) in patients with chronic pancreatitis and an inflammatory mass in the head. An alternative surgical technique to the Whipple operation. Acta Chir Scand, 1990, 156(4): 309-315.
20. Beger HG, Büchler M. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis with inflammatory mass in the head. World J Surg, 1990, 14(1): 83-87.
21. Strate T, Taherpour Z, Bloechle C, et al. Long-term follow-up of a randomized trial comparing the Beger and Frey procedures for patients suffering from chronic pancreatitis. Ann Surg, 2005, 241(4): 591-598.
22. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas, 1987, 2(6): 701-707.
23. 杨尹默, 马永蔌, 高红桥, 等. 慢性胰腺炎的外科治疗及术式评价. 中国实用外科杂志, 2011, 31(9): 788-791.
24. Hong J, Wang J, Keleman AM, et al. Endoscopic versus surgical treatment of downstream pancreatic duct stones in chronic pancreatitis. Am Surg, 2011, 77(11): 1531-1538.
25. Rieder S, Michalski CW, Friess H. Indications for endoscopic or surgical treatment of chronic pancreatitis. Dig Dis, 2010, 28(2): 344-349.
26. Jalleh RP, Willamson RC. Pancreatic exocrine and endocrine function after operations for chronic pancreatitis. Ann Surg, 1992, 216(6): 656-662.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of Clinical Effect of Surgical Treatment for Chronic Pancreatic Head Mass Pancreatitis Combined with Pancreatic Ductal Stones

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