Analysis on Clinical Efficacy of Frey Procedure for Chronic Pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DU Bingqing , CHEN YongHua , GONG Jun , ZHENG ZhenJiang , XIANG Guangming , LIU Xubao , MAI Gang

Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

Keywords：

Chronic pancreatitis; Frey procedures; Perioperative complication; Pancreatic endocrine function; Pancreatic exocrine function; Rate of pain relief

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ObjectiveTo explore clinical efficacy of Frey procedures for chronic pancreatitis. MethodsThirty two patients with chronic pancreatitis who underwent Frey procedures in our hospital from June 2000 to October 2009 were analyzed retrospectively. The rate of perioperative complications, pain relief, and especially endocrine and exocrine function of pancreas in longterm followup (mean 43 months) were analyzed. ResultsNo death occurred in all patients. Fat liquefaction of wound was found in two patients and pancreatic fistula was found in one patient, who was cured by conventional treatment. So the rate of perioperative complications was 9.4%(3/32). After Frey procedures, pain disappeared completely in sixteen patients (50.0%), pain relieved in fourteen patients (43.8%) and two cases were ineffective. Therefore, the rate of pain relief in longterm follow-up was 93.8%. The hospitalization was (11±2) d. After surgical treatment the illness of five patients with diabetes mellitus did not aggravate while new onset of diabetes mellitus was observed in three cases. For three cases who suffered from indigestion and steatorrhea, symptomatic relief was found in one patient treated by oral administration of pancreatin and inefficacy was observed in two cases. But four patients with new steatorrhea were found after operation. ConclusionUnder the strict surgical indications, Frey procedure is a safe and effective surgical method for the treatment of chronic pancreatitis.

Citation： DU Bingqing,CHEN YongHua,GONG Jun,ZHENG ZhenJiang,XIANG Guangming,LIU Xubao,MAI Gang. Analysis on Clinical Efficacy of Frey Procedure for Chronic Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 187-190. doi: Copy

1.	Büchler MW, Friess H, Müller MW, et al. Randomized trial of duodenumpreserving pancreatic head resection versus pyloruspreserving Whipple in chronic pancreatitis [J]. Am J Surg, 1995, 169(1): 6570.
2.	刘续宝. 慢性胰腺炎的诊断和治疗 [J]. 中国普外与基础临床杂志, 2007, 14(4): 385387.
3.	Sakorafas GH, Zobolas B. Lateral pancreatojejunostomy in the surgical management of chronic pancreatitis. Current concepts and future perspectives [J]. Dig Liver Dis, 2001, 33(2): 187191.
4.	Sakorafas GH, Farnell MB, Nagorney DM, et al. Pancreatoduodenectomy for chronic pancreatitis: longterm results in 105 patients [J]. Arch Surg, 2000, 135(5): 517524.
5.	Aspelund G, Topazian MD, Lee JH, et al. Improved outcomes for benign disease with limited pancreatic head resection [J]. J Gastrointest Surg, 2005, 9(3): 400409.
6.	Bachmann K, Mann O, Izbicki JR, et al. Chronic pancreatitis－A surgeons’ view [J]. Med Sci Monit, 2008, 14(11): RA198RA205.
7.	Hildebrand P, Dudertadt S, Czymek R, et al. Different surgical strategies for chronic pancreatitis significantly improve longterm outcome: a comparative single center study [J]. Eur J Med Res, 2010, 15(8): 351356.
8.	Gourgiotis S, Germanos S, Ridolfini MP. Surgical management of chronic pancreatitis [J]. Hepatobiliary Pancreat Dis Int, 2007, 6(2): 121133.
9.	Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis [J]. Gastroenterology, 2000, 119(5): 13241332.
10.	Han SL, Chen J, Zhou HZ, et al. Indications and surgical treatment of chronic pancreatitis [J]. Hepatobiliary Pancreat Dis Int, 2008, 7(6): 638642.
11.	Bachmann K, Kutup A, Mann O, et al. Surgical treatment in chronic pancreatitis timing and type of procedure [J]. Best Pract Res Clin Gastroenterol, 2010, 24(3): 299310.
12.	MacLaren IF. Observations and surgical management of chronic pancreatitis in the British Isles: a review of the twentieth century [J]. World J Surg, 1990, 14(1): 1927.
13.	Schlosser W, Poch B, Beger HG. Duodenumpreserving pancreatic head resection leads to relief of common bile duct stenosis [J]. Am J Surg, 2002, 183(1): 3741.
14.	Müller MW, Friess H, Beger HG, et al. Gastric emptying following pyloruspreserving Whipple and duodenumpreserving pancreatic head resection in patients with chronic pancreatitis [J]. Am J Surg,1997, 173(4): 257263.
15.	田孝东, 杨尹默, 庄岩, 等. 胰管结石性慢性胰腺炎的临床特点与外科治疗 [J]. 国际外科学杂志, 2007, 34(9): 595598.
16.	刘续宝, 张肇达. 慢性胰腺炎的手术治疗 [J]. 中国普外与基础临床杂志, 2003, 10(6): 530531, 534.
17.	Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis [J]. Ann Surg, 2010, 251(1): 1832.
18.	Negi S, Singh A, Chaudhary A. Pain relief after Frey’s procedure for chronic pancreatitis [J]. Br J Surg, 2010, 97(7): 10871095.
19.	Amudhan A, Balachandar TG, Kannan DG, et al. Factors affecting outcome after Frey procedure for chronic pancreatitis [J]. HPB (Oxford), 2008, 10(6): 477482.
20.	Gall FP, Gebhardt C, Meister R, et al. Severe chronic cephalic pancreatitis: use of partial duodenopancreatectomy with occlusion of the pancreatic duct in 289 patients [J]. World J Surg, 1989, 13(6): 809817.
21.	Pessaux P, Kianmanesh R, Regimbeau JM, et al. Frey procedure in the treatment of chronic pancreatitis: shortterm results [J]. Pancreas, 2006, 33(4): 354358.
22.	Ramesh H, Jacob G, Lekha V, et al. Ductal drainage with head coring in chronic pancreatitis with smallduct disease [J]. J Hepatobiliary Pancreat Surg, 2003, 10(5): 366372.
23.	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 [J]. Ann Surg, 2005, 241(4): 591598.
24.	Talamini G, Falconi M, Bassi C, et al. Incidence of cancer in the course of chronic pancreatitis [J]. Am J Gastroenterol, 1999, 94(5): 12531260.
25.	Prinz RA, Greenlee HB. Pancreatic duct drainage in 100 patients with chronic pancreatitis [J]. Ann Surg, 1981, 194(3): 313320.
26.	赵玉沛, 李秉璐. 慢性胰腺炎与胰腺癌的关系及诊治现状与展望 [J]. 中国普外基础与临床杂志, 2003, 11(6): 521522.
27.	Pickartz T, Mayerle J, Kraft M, et al. Chronic pancreatitis as a risk factor for the development of pancreatic cancer－diagnostic challenges [J]. Med Klin (Munich), 2010, 105(4): 281285.

1. Büchler MW, Friess H, Müller MW, et al. Randomized trial of duodenumpreserving pancreatic head resection versus pyloruspreserving Whipple in chronic pancreatitis [J]. Am J Surg, 1995, 169(1): 6570.
2. 刘续宝. 慢性胰腺炎的诊断和治疗 [J]. 中国普外与基础临床杂志, 2007, 14(4): 385387.
3. Sakorafas GH, Zobolas B. Lateral pancreatojejunostomy in the surgical management of chronic pancreatitis. Current concepts and future perspectives [J]. Dig Liver Dis, 2001, 33(2): 187191.
4. Sakorafas GH, Farnell MB, Nagorney DM, et al. Pancreatoduodenectomy for chronic pancreatitis: longterm results in 105 patients [J]. Arch Surg, 2000, 135(5): 517524.
5. Aspelund G, Topazian MD, Lee JH, et al. Improved outcomes for benign disease with limited pancreatic head resection [J]. J Gastrointest Surg, 2005, 9(3): 400409.
6. Bachmann K, Mann O, Izbicki JR, et al. Chronic pancreatitis－A surgeons’ view [J]. Med Sci Monit, 2008, 14(11): RA198RA205.
7. Hildebrand P, Dudertadt S, Czymek R, et al. Different surgical strategies for chronic pancreatitis significantly improve longterm outcome: a comparative single center study [J]. Eur J Med Res, 2010, 15(8): 351356.
8. Gourgiotis S, Germanos S, Ridolfini MP. Surgical management of chronic pancreatitis [J]. Hepatobiliary Pancreat Dis Int, 2007, 6(2): 121133.
9. Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis [J]. Gastroenterology, 2000, 119(5): 13241332.
10. Han SL, Chen J, Zhou HZ, et al. Indications and surgical treatment of chronic pancreatitis [J]. Hepatobiliary Pancreat Dis Int, 2008, 7(6): 638642.
11. Bachmann K, Kutup A, Mann O, et al. Surgical treatment in chronic pancreatitis timing and type of procedure [J]. Best Pract Res Clin Gastroenterol, 2010, 24(3): 299310.
12. MacLaren IF. Observations and surgical management of chronic pancreatitis in the British Isles: a review of the twentieth century [J]. World J Surg, 1990, 14(1): 1927.
13. Schlosser W, Poch B, Beger HG. Duodenumpreserving pancreatic head resection leads to relief of common bile duct stenosis [J]. Am J Surg, 2002, 183(1): 3741.
14. Müller MW, Friess H, Beger HG, et al. Gastric emptying following pyloruspreserving Whipple and duodenumpreserving pancreatic head resection in patients with chronic pancreatitis [J]. Am J Surg,1997, 173(4): 257263.
15. 田孝东, 杨尹默, 庄岩, 等. 胰管结石性慢性胰腺炎的临床特点与外科治疗 [J]. 国际外科学杂志, 2007, 34(9): 595598.
16. 刘续宝, 张肇达. 慢性胰腺炎的手术治疗 [J]. 中国普外与基础临床杂志, 2003, 10(6): 530531, 534.
17. Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis [J]. Ann Surg, 2010, 251(1): 1832.
18. Negi S, Singh A, Chaudhary A. Pain relief after Frey’s procedure for chronic pancreatitis [J]. Br J Surg, 2010, 97(7): 10871095.
19. Amudhan A, Balachandar TG, Kannan DG, et al. Factors affecting outcome after Frey procedure for chronic pancreatitis [J]. HPB (Oxford), 2008, 10(6): 477482.
20. Gall FP, Gebhardt C, Meister R, et al. Severe chronic cephalic pancreatitis: use of partial duodenopancreatectomy with occlusion of the pancreatic duct in 289 patients [J]. World J Surg, 1989, 13(6): 809817.
21. Pessaux P, Kianmanesh R, Regimbeau JM, et al. Frey procedure in the treatment of chronic pancreatitis: shortterm results [J]. Pancreas, 2006, 33(4): 354358.
22. Ramesh H, Jacob G, Lekha V, et al. Ductal drainage with head coring in chronic pancreatitis with smallduct disease [J]. J Hepatobiliary Pancreat Surg, 2003, 10(5): 366372.
23. 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 [J]. Ann Surg, 2005, 241(4): 591598.
24. Talamini G, Falconi M, Bassi C, et al. Incidence of cancer in the course of chronic pancreatitis [J]. Am J Gastroenterol, 1999, 94(5): 12531260.
25. Prinz RA, Greenlee HB. Pancreatic duct drainage in 100 patients with chronic pancreatitis [J]. Ann Surg, 1981, 194(3): 313320.
26. 赵玉沛, 李秉璐. 慢性胰腺炎与胰腺癌的关系及诊治现状与展望 [J]. 中国普外基础与临床杂志, 2003, 11(6): 521522.
27. Pickartz T, Mayerle J, Kraft M, et al. Chronic pancreatitis as a risk factor for the development of pancreatic cancer－diagnostic challenges [J]. Med Klin (Munich), 2010, 105(4): 281285.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on Clinical Efficacy of Frey Procedure for Chronic Pancreatitis

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