Different surgical strategies for chronic pancreatitis significantly improve long-term outcome: a comparative single center study

European Journal of Medical Research

T Jungbluth²  H-P Bruch²  UJ Roblick²  FG Bader²  R Czymek²  S Dudertadt¹  P Hildebrand² 

[1] Department of Internal Medicine, University of Schleswig-Holstein, Campus Lübeck, Germany;Department of Surgery, University of Schleswig-Holstein, Campus Lübeck, Germany

关键词: Pain score;    Whipple operation;    Frey procedure;    Chronic pancreatitis;   

Others  :  1093199
DOI  :  10.1186/2047-783X-15-8-351

 received in 2009-12-19, accepted in 2010-03-16,  发布年份 2010

【 摘 要 】

Objective

In general, chronic pancreatitis (CP) primarily requires conservative treatment. The chronic pain syndrome and complications make patients seek surgical advice, frequently after years of progression. In the past, surgical procedures involving drainage as well as resection have been employed successfully. The present study compared the different surgical strategies.

Patients and Methods

From March 2000 until April 2005, a total of 51 patients underwent surgical treatment for CP at the Department of surgery, University of Schleswig-Holstein, Campus Lübeck. Out of those 51 patients, 39 (76.5%) were operated according to the Frey procedure, and in 12 cases (23.5%) the Whipple procedure was performed. Patient data were documented prospectively throughout the duration of the hospital stay. The evaluation of the postoperative pain score was carried out retrospectively with a validated questionnaire.

Results

Average operating time was 240 minutes for the Frey group and 411 minutes for the Whipple group. The medium number of blood transfusions was 1 in the Frey group and 4.5 in the Whipple group. Overall morbidity was 21% in the Frey group and 42% in the Whipple group. 30-day mortality was zero for all patients. During the median follow-up period of 50 months, an improvement in pain score was observed in 93% of the patients of the Frey group and 67% of the patients treated according to the Whipple procedure.

Conclusion

The results show that both the Frey procedure as well as partial pancreaticoduodenectomy are capable of improving chronic pain symptoms in CP. As far as later endocrine and exocrine pancreatic insufficiency is concerned, however, the extended drainage operation according to Frey proves to be advantageous compared to the traditional resection procedure by Whipple. Accordingly, the Frey procedure provides us with an organ-preserving surgical procedure which treats the complications of CP sufficiently, thus being an alternative to partial pancreaticoduodenectomy if there is no suspicion of malignancy.

【 授权许可】

   
2010 I. Holzapfel Publishers

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