- Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;
ObjectiveTo review the current clinical application of Beger procedure and Frey procedure for benign disease or low-grade malignant potential lesion of pancreas. MethodsRelevant literatures about current advance of clinical application of Beger procedure and Frey procedure published recently of domestic and abroad were collected and reviewed. ResultsWith the concept of organ-preserving operations was adopted in recent years, Beger procedure and Frey procedure were applied generally. Beger procedure and Frey procedure were associated with tolerable perioperative risk, postoperative complications, and good outcomes in the aspects of preservation of function and curability in these lesions compared to conventional pancreatectomy, with preservation of the physiological food passage, thus patients gained weight faster, had less pain, and demonstrated better exocrine and endocrine pancreatic function postoperatively and an improvement in the quality of life. Both procedures had reached an international position as a standard operation for the treatment of benign disease or low-grade malignant potential lesion of pancreas. But after long-term following-up early advantages were no longer present. ConclusionsBeger procedure and Frey procedure are safe and effective in providing good outcomes in the aspects of preservation of function and curability in benign disease or low-grade malignant potential lesion of pancreas. Organ-preserving pancreatectomy could become a new organ-preserving standard operation.
Citation: CHEN Yonghua,DU Bingqing,XIANG Guangming,ZHENG Zhenjiang,LIU Xubao,MAI Gang.. Clinical Application of Beger Procedure and Frey Procedure for Benign Disease or Low-Grade Malignant Potential Lesion of Pancreas. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(3): 341-347. doi: Copy
1. | Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenumsparing pancreas head resection in chronic pancreatitis [J]. Chirurg, 1980, 51(5): 303307. |
2. | Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis [J]. Pancreas, 1987, 2(6): 701707. |
3. | Müller MW, Friess H, Leitzbach S, et al. Perioperative and followup results after central pancreatic head resection (Berne technique) in a consecutive series of patients with chronic pancreatitis [J]. Am J Surg, 2008, 196(3): 364372. |
4. | Strobel O, Büchler MW, Werner J. Surgical therapy of chronic pancreatitis: indications, techniques and results [J]. Int J Surg, 2009, 7(4): 305312. |
5. | Varghese TK, Bell RH Jr. Duodenumpreserving head resection for chronic pancreatitis: an institutional experience and national survey of usage [J]. Surgery, 2007, 142(4): 588593. |
6. | Lee SE, Jang JY, Hwang DW, et al. Clinical efficacy of organpreserving pancreatectomy for benign or lowgrade malignant potential lesion [J]. J Korean Med Sci, 2010, 25(1): 97103. |
7. | Bell RH Jr. Atlas of pancreatic surgery//Bell RH Jr, Rikkers LF, Mulholland MW. Digestive trac surgery. A text and Atlas [M]. Philadelphia, PA: Lippincott Raven, 1996: 10141015. |
8. | Horiguchi A, Miyakawa S, Ishihara S, et al. Surgical design and outcome of duodenumpreserving pancreatic head resection for benign or lowgrade malignant tumors [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 792797. |
9. | 刘续宝, 肖乾虎. 腹部外科手术要点及围手术期处理 [M]. 北京: 科学出版社, 2010: 436437. |
10. | Kat’uchová J, Bober J, Závacky P. Chronic pancreatitis, indications for resection procedures and postoperative complications [J]. Rozhl Chir, 2008, 87(4): 200206. |
11. | Chirletti P, Peparini N, Caronna R, et al. RouxenY endtoend and endtoside double pancreaticojejunostomy: application of the reconstructive method of the Beger procedure to central pancreatectomy [J]. Langenbecks Arch Surg, 2010, 395(1): 8993. |
12. | Hatori T, Imaizumi T, Harada N, et al. Appraisal of the Imaizumi modification of the Beger procedure: the TWMU experience [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 752757. |
13. | Cataldegirmen G, Bogoevski D, Mann O, et al. Late morbidity after duodenumpreserving pancreatic head resection with bile duct reinsertion into the resection cavity [J]. Br J Surg, 2008, 95(4): 447452. |
14. | Beger HG, Schlosser W, Friess HM, et al. Duodenumpreserving head resection in chronic pancreatitis changes the natural course of the disease: a singlecenter 26year experience [J]. Ann Surg, 1999, 230(4): 512519. |
15. | Mihaljevic AL, Kleeff J, Friess H. Beger’s operation and the Berne modification: origin and current results [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 735744. |
16. | Gloor B, Friess H, Uhl W, et al. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis [J]. Dig Surg, 2001, 18(1): 2125. |
17. | 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): 400409. |
18. | Farkas G, Leindler L, Daróczi M, et al. Prospective randomised comparison of organpreserving pancreatic head resection with pyloruspreserving pancreaticoduodenectomy [J]. Langenbecks Arch Surg, 2006, 391(4): 338342. |
19. | Riediger H, Adam U, Fischer E, et al. Longterm outcome after resection for chronic pancreatitis in 224 patients [J]. J Gastrointest Surg, 2007, 11(8): 949959. |
20. | Diener MK, Bruckner T, Contin P, et al. ChroPactrial: duodenumpreserving pancreatic head resection versus pancreatoduodenectomy for chronic pancreatitis. Trial protocol of a randomised controlled multicentre trial [J]. Trials, 2010, 11: 47. |
21. | Busquets J, Fabregat J, Borobia FG, et al. Organpreserving surgery for benign lesions and lowgrade malignancies of the pancreatic head: a matched casecontrol study [J]. Surg Today, 2010, 40(2): 125131. |
22. | Frey CF, Mayer KL. Comparison of local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure) and duodenumpreserving resection of the pancreatic head (Beger procedure) [J]. World J Surg, 2003, 27(11): 12171230. |
23. | 郑振江, 刘续宝, 麦刚, 等. 胰十二指肠切除术和保留十二指肠的胰头切除术治疗慢性胰腺炎的临床疗效比较 [J]. 四川大学学报(医学版) , 2008, 39(4): 686687. |
24. | Egawa S, Motoi F, Sakata N, et al. Assessment of Frey procedures: Japanese experience [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 745751. |
25. | Schneider CG, Cataldegirmen G, Mann O, et al. Lateral anastomosis techniques: PartingtonRochelle and Vshaped excision [J]. Chirurg, 2009, 80(1): 2833. |
26. | Strobel O, Büchler MW, Werner J. Duodenumpreserving pancreatic head resection: technique according to Beger, technique according to Frey and Berne modifications [J]. Chirurg, 2009, 80(1): 2227. |
27. | Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis [J]. Ann Surg, 2010, 251(1): 1832. |
28. | Ebbehj N, Borly L, Bülow J, et al. Pancreatic tissue fluid pressure in chronic pancreatitis. Relation to pain, morphology, and function [J]. Scand J Gastroenterol, 1990, 25(10): 10461051. |
29. | Di Sebastiano P, di Mola FF, Bockman DE, et al. Chronic pancreatitis: the perspective of pain generation by neuroimmune interaction [J]. Gut, 2003, 52(6): 907911. |
30. | Zhu ZW, Friess H, Wang L, et al. Brainderived neurotrophic factor (BDNF) is upregulated and associated with pain in chronic pancreatitis [J]. Dig Dis Sci, 2001, 46(8): 16331639. |
31. | Beger HG, Schlosser W, Poch B, et al. Inflammatory mass in the head of pancreas//Beger HG, Warshaw AL, Büchler MW, et al. The pancreas [M]. Oxford: Blackwell Science, 1998: 757760. |
32. | Schlosser W, Siech M, Grich J, et al. Common bile duct stenosis in complicated chronic pancreatitis [J]. Scand J Gastroenterol, 2001, 36(2): 214219. |
33. | Heider TR, Azeem S, Galanko JA, et al. The natural history of pancreatitisinduced splenic vein thrombosis [J]. Ann Surg, 2004, 239(6): 876880. |
34. | Rieder S, Michalski CW, Friess H. Indications for endoscopic or surgical treatment of chronic pancreatitis [J]. Dig Dis, 2010, 28(2): 344349. |
35. | Isaji S. Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 763769. |
36. | Menge BA, Schrader H, Breuer TG, et al. Metabolic consequences of a 50% partial pancreatectomy in humans [J]. Diabetologia, 2009, 52(2): 306317. |
37. | Diener MK, Rahbari NN, Fischer L, et al. Duodenumpreserving pancreatic head resection versus pancreatoduodenectomy for surgical treatment of chronic pancreatitis: a systematic review and metaanalysis [J]. Ann Surg, 2008, 247(6): 950961. |
38. | Mihaljevic AL, Kleeff J, Friess H, et al. Surgical approaches to chronic pancreatitis [J]. Best Pract Res Clin Gastroenterol, 2008, 22(1): 167181. |
39. | 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): 299310. |
40. | Müller MW, Friess H, Martin DJ, et al. Longterm followup of a randomized clinical trial comparing Beger with pyloruspreserving Whipple procedure for chronic pancreatitis [J]. Br J Surg, 2008, 95(3): 350356. |
41. | McClaine RJ, Lowy AM, Matthews JB, et al. A comparison of pancreaticoduodenectomy and duodenumpreserving head resection for the treatment of chronic pancreatitis [J]. HPB (Oxford), 2009, 11(8): 677683. |
42. | Strate T, Taherpour Z, Bloechle C, et al. Longterm followup of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis [J]. Ann Surg, 2005, 241(4): 591598. |
43. | Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis [J]. Gastroenterology, 2000, 119(5): 13241332. |
44. | Izbicki JR, Bloechle C, Knoefel WT, et al. Duodenumpreserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial [J]. Ann Surg, 1995, 221(4): 350358. |
45. | Keck T, Wellner UF, Riediger H, et al. Longterm outcome after 92 duodenumpreserving pancreatic head resections for chronic pancreatitis: comparison of Beger and Frey procedures [J]. J Gastrointest Surg, 2010, 14(3): 549556. |
46. | Keck T, Marjanovic G, Fernandezdel Castillo C, et al. The inflammatory pancreatic head mass: significant differences in the anatomic pathology of German and American patients with chronic pancreatitis determine very different surgical strategies [J]. Ann Surg, 2009, 249(1): 105110. |
47. | Amudhan A, Balachandar TG, Kannan DG, et al. Factors affecting outcome after Frey procedure for chronic pancreatitis [J]. HPB (Oxford), 2008, 10(6): 477482. |
48. | 刘续宝, 龚军. 慢性胰腺炎的手术治疗方式 [J]. 临床外科杂志, 2009, 17(6): 378380. |
49. | Uguz A, Yakan S, Gurcu B, et al. Xanthogranulomatous pancreatitis treated by duodenumpreserving pancreatic head resection [J]. Hepatobiliary Pancreat Dis Int, 2010, 9(2): 216218. |
50. | Beger HG, Rau BM. New advances in pancreatic surgery [J]. Curr Opin Gastroenterol, 2007, 23(5): 522534. |
51. | Salvia R, Crippa S, Falconi M, et al. Branchduct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? [J]. Gut, 2007, 56(8): 10861090. |
52. | Longnecker DS, Adler G, Hruban RH, et al. Intraductal papillary mucinous neoplasms of the pancreas//Hamilton SR, Aaltonen LA. World Health Organization classification of tumors. Pathology and genetics of tumors of the digestive system [M]. Lyon: IARC Press, 2000: 237241. |
53. | Sarr MG, Murr M, Smyrk TC, et al. Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importancecurrent stateoftheart and unanswered questions [J]. J Gastrointest Surg, 2003, 7(3): 417428. |
54. | Tanaka M, Chari S, Adsay V, et al, International Association of Pancreatology. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas [J]. Pancreatology, 2006, 6(12): 1732. |
55. | Beger HG, Rau BM, Gansauge F, et al. Duodenumpreserving total pancreatic head resection for cystic neoplasm: a limited but cancerpreventive procedure [J]. Langenbecks Arch Surg, 2008, 393(4): 589598. |
56. | Kimura W. IHPBA in Tokyo, 2002: surgical treatment of IPMT vs MCT: a Japanese experience [J]. J Hepatobiliary Pancreat Surg, 2003, 10(2): 156162. |
57. | Beger HG, Gansauge F, Siech M, et al. Duodenumpreserving total pancreatic head resection for cystic neoplastic lesions in the head of the pancreas [J]. J Hepatobiliary Pancreat Surg, 2008, 15(2): 149156. |
58. | Beger HG, Rau BM, Gansauge F, et al. Duodenumpreserving subtotal and total pancreatic head resections for inflammatory and cystic neoplastic lesions of the pancreas [J]. J Gastrointest Surg, 2008, 12(6): 11271132. |
59. | Wang C, Liu T, Wu H, et al. Duodenumpreserving total pancreatic head resection without segment resection of the duodenum for chronic pancreatitis [J]. Langenbecks Arch Surg, 2009, 394(3): 563568. |
60. | Pedrazzoli S, Canton SA, Sperti C. Duodenumpreserving versus pyloruspreserving pancreatic head resection for benign and premalignant lesions [J]. J Hepatobiliary Pancreat Sci, 2010 Aug 7 [Epub ahead of print]. |
61. | Hirano S, Kondo S, Ambo Y, et al. Outcome of duodenumpreserving resection of the head of the pancreas for intraductal papillarymucinous neoplasm [J]. Dig Surg, 2004, 21(3): 242245. |
62. | Kanazumi N, Nakao A, Kaneko T, et al. Surgical treatment of intraductal papillarymucinous tumors of the pancreas [J]. Hepatogastroenterology, 2001, 48(40): 967971. |
63. | Schütte K, Bornschein J, Kuester D, et al. Fulminant duodenal bleeding as first manifestation of a neuroendocrine carcinoma of the pancreatic head [J]. Med Klin (Munich), 2010, 105(4): 291295. |
64. | Schlosser W, Rau BM, Poch B, et al. Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits of duodenumpreserving pancreatic head resection [J]. J Gastrointest Surg, 2005, 9(5): 710715. |
65. | 王雪峰, 刘颖斌. 胰腺创伤的诊治 [J]. 肝胆外科杂志, 2009, 17(5): 330331. |
- 1. Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenumsparing pancreas head resection in chronic pancreatitis [J]. Chirurg, 1980, 51(5): 303307.
- 2. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis [J]. Pancreas, 1987, 2(6): 701707.
- 3. Müller MW, Friess H, Leitzbach S, et al. Perioperative and followup results after central pancreatic head resection (Berne technique) in a consecutive series of patients with chronic pancreatitis [J]. Am J Surg, 2008, 196(3): 364372.
- 4. Strobel O, Büchler MW, Werner J. Surgical therapy of chronic pancreatitis: indications, techniques and results [J]. Int J Surg, 2009, 7(4): 305312.
- 5. Varghese TK, Bell RH Jr. Duodenumpreserving head resection for chronic pancreatitis: an institutional experience and national survey of usage [J]. Surgery, 2007, 142(4): 588593.
- 6. Lee SE, Jang JY, Hwang DW, et al. Clinical efficacy of organpreserving pancreatectomy for benign or lowgrade malignant potential lesion [J]. J Korean Med Sci, 2010, 25(1): 97103.
- 7. Bell RH Jr. Atlas of pancreatic surgery//Bell RH Jr, Rikkers LF, Mulholland MW. Digestive trac surgery. A text and Atlas [M]. Philadelphia, PA: Lippincott Raven, 1996: 10141015.
- 8. Horiguchi A, Miyakawa S, Ishihara S, et al. Surgical design and outcome of duodenumpreserving pancreatic head resection for benign or lowgrade malignant tumors [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 792797.
- 9. 刘续宝, 肖乾虎. 腹部外科手术要点及围手术期处理 [M]. 北京: 科学出版社, 2010: 436437.
- 10. Kat’uchová J, Bober J, Závacky P. Chronic pancreatitis, indications for resection procedures and postoperative complications [J]. Rozhl Chir, 2008, 87(4): 200206.
- 11. Chirletti P, Peparini N, Caronna R, et al. RouxenY endtoend and endtoside double pancreaticojejunostomy: application of the reconstructive method of the Beger procedure to central pancreatectomy [J]. Langenbecks Arch Surg, 2010, 395(1): 8993.
- 12. Hatori T, Imaizumi T, Harada N, et al. Appraisal of the Imaizumi modification of the Beger procedure: the TWMU experience [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 752757.
- 13. Cataldegirmen G, Bogoevski D, Mann O, et al. Late morbidity after duodenumpreserving pancreatic head resection with bile duct reinsertion into the resection cavity [J]. Br J Surg, 2008, 95(4): 447452.
- 14. Beger HG, Schlosser W, Friess HM, et al. Duodenumpreserving head resection in chronic pancreatitis changes the natural course of the disease: a singlecenter 26year experience [J]. Ann Surg, 1999, 230(4): 512519.
- 15. Mihaljevic AL, Kleeff J, Friess H. Beger’s operation and the Berne modification: origin and current results [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 735744.
- 16. Gloor B, Friess H, Uhl W, et al. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis [J]. Dig Surg, 2001, 18(1): 2125.
- 17. 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): 400409.
- 18. Farkas G, Leindler L, Daróczi M, et al. Prospective randomised comparison of organpreserving pancreatic head resection with pyloruspreserving pancreaticoduodenectomy [J]. Langenbecks Arch Surg, 2006, 391(4): 338342.
- 19. Riediger H, Adam U, Fischer E, et al. Longterm outcome after resection for chronic pancreatitis in 224 patients [J]. J Gastrointest Surg, 2007, 11(8): 949959.
- 20. Diener MK, Bruckner T, Contin P, et al. ChroPactrial: duodenumpreserving pancreatic head resection versus pancreatoduodenectomy for chronic pancreatitis. Trial protocol of a randomised controlled multicentre trial [J]. Trials, 2010, 11: 47.
- 21. Busquets J, Fabregat J, Borobia FG, et al. Organpreserving surgery for benign lesions and lowgrade malignancies of the pancreatic head: a matched casecontrol study [J]. Surg Today, 2010, 40(2): 125131.
- 22. Frey CF, Mayer KL. Comparison of local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure) and duodenumpreserving resection of the pancreatic head (Beger procedure) [J]. World J Surg, 2003, 27(11): 12171230.
- 23. 郑振江, 刘续宝, 麦刚, 等. 胰十二指肠切除术和保留十二指肠的胰头切除术治疗慢性胰腺炎的临床疗效比较 [J]. 四川大学学报(医学版) , 2008, 39(4): 686687.
- 24. Egawa S, Motoi F, Sakata N, et al. Assessment of Frey procedures: Japanese experience [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 745751.
- 25. Schneider CG, Cataldegirmen G, Mann O, et al. Lateral anastomosis techniques: PartingtonRochelle and Vshaped excision [J]. Chirurg, 2009, 80(1): 2833.
- 26. Strobel O, Büchler MW, Werner J. Duodenumpreserving pancreatic head resection: technique according to Beger, technique according to Frey and Berne modifications [J]. Chirurg, 2009, 80(1): 2227.
- 27. Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis [J]. Ann Surg, 2010, 251(1): 1832.
- 28. Ebbehj N, Borly L, Bülow J, et al. Pancreatic tissue fluid pressure in chronic pancreatitis. Relation to pain, morphology, and function [J]. Scand J Gastroenterol, 1990, 25(10): 10461051.
- 29. Di Sebastiano P, di Mola FF, Bockman DE, et al. Chronic pancreatitis: the perspective of pain generation by neuroimmune interaction [J]. Gut, 2003, 52(6): 907911.
- 30. Zhu ZW, Friess H, Wang L, et al. Brainderived neurotrophic factor (BDNF) is upregulated and associated with pain in chronic pancreatitis [J]. Dig Dis Sci, 2001, 46(8): 16331639.
- 31. Beger HG, Schlosser W, Poch B, et al. Inflammatory mass in the head of pancreas//Beger HG, Warshaw AL, Büchler MW, et al. The pancreas [M]. Oxford: Blackwell Science, 1998: 757760.
- 32. Schlosser W, Siech M, Grich J, et al. Common bile duct stenosis in complicated chronic pancreatitis [J]. Scand J Gastroenterol, 2001, 36(2): 214219.
- 33. Heider TR, Azeem S, Galanko JA, et al. The natural history of pancreatitisinduced splenic vein thrombosis [J]. Ann Surg, 2004, 239(6): 876880.
- 34. Rieder S, Michalski CW, Friess H. Indications for endoscopic or surgical treatment of chronic pancreatitis [J]. Dig Dis, 2010, 28(2): 344349.
- 35. Isaji S. Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence [J]. J Hepatobiliary Pancreat Sci, 2010, 17(6): 763769.
- 36. Menge BA, Schrader H, Breuer TG, et al. Metabolic consequences of a 50% partial pancreatectomy in humans [J]. Diabetologia, 2009, 52(2): 306317.
- 37. Diener MK, Rahbari NN, Fischer L, et al. Duodenumpreserving pancreatic head resection versus pancreatoduodenectomy for surgical treatment of chronic pancreatitis: a systematic review and metaanalysis [J]. Ann Surg, 2008, 247(6): 950961.
- 38. Mihaljevic AL, Kleeff J, Friess H, et al. Surgical approaches to chronic pancreatitis [J]. Best Pract Res Clin Gastroenterol, 2008, 22(1): 167181.
- 39. 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): 299310.
- 40. Müller MW, Friess H, Martin DJ, et al. Longterm followup of a randomized clinical trial comparing Beger with pyloruspreserving Whipple procedure for chronic pancreatitis [J]. Br J Surg, 2008, 95(3): 350356.
- 41. McClaine RJ, Lowy AM, Matthews JB, et al. A comparison of pancreaticoduodenectomy and duodenumpreserving head resection for the treatment of chronic pancreatitis [J]. HPB (Oxford), 2009, 11(8): 677683.
- 42. Strate T, Taherpour Z, Bloechle C, et al. Longterm followup of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis [J]. Ann Surg, 2005, 241(4): 591598.
- 43. Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis [J]. Gastroenterology, 2000, 119(5): 13241332.
- 44. Izbicki JR, Bloechle C, Knoefel WT, et al. Duodenumpreserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial [J]. Ann Surg, 1995, 221(4): 350358.
- 45. Keck T, Wellner UF, Riediger H, et al. Longterm outcome after 92 duodenumpreserving pancreatic head resections for chronic pancreatitis: comparison of Beger and Frey procedures [J]. J Gastrointest Surg, 2010, 14(3): 549556.
- 46. Keck T, Marjanovic G, Fernandezdel Castillo C, et al. The inflammatory pancreatic head mass: significant differences in the anatomic pathology of German and American patients with chronic pancreatitis determine very different surgical strategies [J]. Ann Surg, 2009, 249(1): 105110.
- 47. Amudhan A, Balachandar TG, Kannan DG, et al. Factors affecting outcome after Frey procedure for chronic pancreatitis [J]. HPB (Oxford), 2008, 10(6): 477482.
- 48. 刘续宝, 龚军. 慢性胰腺炎的手术治疗方式 [J]. 临床外科杂志, 2009, 17(6): 378380.
- 49. Uguz A, Yakan S, Gurcu B, et al. Xanthogranulomatous pancreatitis treated by duodenumpreserving pancreatic head resection [J]. Hepatobiliary Pancreat Dis Int, 2010, 9(2): 216218.
- 50. Beger HG, Rau BM. New advances in pancreatic surgery [J]. Curr Opin Gastroenterol, 2007, 23(5): 522534.
- 51. Salvia R, Crippa S, Falconi M, et al. Branchduct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? [J]. Gut, 2007, 56(8): 10861090.
- 52. Longnecker DS, Adler G, Hruban RH, et al. Intraductal papillary mucinous neoplasms of the pancreas//Hamilton SR, Aaltonen LA. World Health Organization classification of tumors. Pathology and genetics of tumors of the digestive system [M]. Lyon: IARC Press, 2000: 237241.
- 53. Sarr MG, Murr M, Smyrk TC, et al. Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importancecurrent stateoftheart and unanswered questions [J]. J Gastrointest Surg, 2003, 7(3): 417428.
- 54. Tanaka M, Chari S, Adsay V, et al, International Association of Pancreatology. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas [J]. Pancreatology, 2006, 6(12): 1732.
- 55. Beger HG, Rau BM, Gansauge F, et al. Duodenumpreserving total pancreatic head resection for cystic neoplasm: a limited but cancerpreventive procedure [J]. Langenbecks Arch Surg, 2008, 393(4): 589598.
- 56. Kimura W. IHPBA in Tokyo, 2002: surgical treatment of IPMT vs MCT: a Japanese experience [J]. J Hepatobiliary Pancreat Surg, 2003, 10(2): 156162.
- 57. Beger HG, Gansauge F, Siech M, et al. Duodenumpreserving total pancreatic head resection for cystic neoplastic lesions in the head of the pancreas [J]. J Hepatobiliary Pancreat Surg, 2008, 15(2): 149156.
- 58. Beger HG, Rau BM, Gansauge F, et al. Duodenumpreserving subtotal and total pancreatic head resections for inflammatory and cystic neoplastic lesions of the pancreas [J]. J Gastrointest Surg, 2008, 12(6): 11271132.
- 59. Wang C, Liu T, Wu H, et al. Duodenumpreserving total pancreatic head resection without segment resection of the duodenum for chronic pancreatitis [J]. Langenbecks Arch Surg, 2009, 394(3): 563568.
- 60. Pedrazzoli S, Canton SA, Sperti C. Duodenumpreserving versus pyloruspreserving pancreatic head resection for benign and premalignant lesions [J]. J Hepatobiliary Pancreat Sci, 2010 Aug 7 [Epub ahead of print].
- 61. Hirano S, Kondo S, Ambo Y, et al. Outcome of duodenumpreserving resection of the head of the pancreas for intraductal papillarymucinous neoplasm [J]. Dig Surg, 2004, 21(3): 242245.
- 62. Kanazumi N, Nakao A, Kaneko T, et al. Surgical treatment of intraductal papillarymucinous tumors of the pancreas [J]. Hepatogastroenterology, 2001, 48(40): 967971.
- 63. Schütte K, Bornschein J, Kuester D, et al. Fulminant duodenal bleeding as first manifestation of a neuroendocrine carcinoma of the pancreatic head [J]. Med Klin (Munich), 2010, 105(4): 291295.
- 64. Schlosser W, Rau BM, Poch B, et al. Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits of duodenumpreserving pancreatic head resection [J]. J Gastrointest Surg, 2005, 9(5): 710715.
- 65. 王雪峰, 刘颖斌. 胰腺创伤的诊治 [J]. 肝胆外科杂志, 2009, 17(5): 330331.