Outcomes after Frey’s procedure for chronic pancreatitis: a 8-year single-center experience in Colombia

BMC Surgery

Research

Juan Carlos Sabogal Olarte¹  Carlos Eduardo Rey Chaves²  Daniela Ayala³  Juliana González³  Nicolás Caballero³  Danny Conde⁴ 

[1] Hospital Universitario Mayor Méderi, Bogotá, Colombia;School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia;111011, Bogotá D.C, Colombia;School of Medicine, Universidad del Rosario, Bogotá, Colombia;School of Medicine, Universidad del Rosario, Bogotá, Colombia;Hospital Universitario Mayor Méderi, Bogotá, Colombia;

关键词: Chronic pancreatitis;    Frey procedure;    Pancreatojejunostomy;    Pancreatic surgery;    Pancreatic cancer;    Abdominal pain;    Follow-up;   

DOI  :  10.1186/s12893-022-01839-x

 received in 2022-07-28, accepted in 2022-11-03,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundChronic pancreatitis is an inflammatory disease characterized by irreversible morphological changes due to chronic pancreatic fibrosis. The treatment goals are to relieve pain, preserve function, and prevent further pathological consequences. Endoscopic treatment, surgery, or both are options for untreatable pain or suspected malignancy. Frey procedure is a reasonable surgical intervention because of its hybrid character, combining resection and drainage. Unfortunately, there is limited information about the outcomes of this procedure in Latin America, and few cases described in Colombia. This study aims to describe the experience of a pancreatic surgery reference center in the management of patients undergoing Frey’s surgery for chronic pancreatitis.MethodsA retrospective review of a prospectively collected database of patients who underwent a Frey procedure due to chronic pancreatitis between January 2014 to February 2022 in a hospital in Bogotá, Colombia, was made. A demographic, clinical, and postoperative outcome description was performed. Mann–Whitney Willcoxon test was performed between operative variables and long-term outcomes.ResultsEighteen patients met the inclusion criteria. 55.5% of patients were male. Chronic pancreatitis etiology in most cases (83.3% n = 15) was idiopathic. The median duration of symptoms and chronic pancreatitis diagnosis before surgery was 6.15 months (IQR 5;97). Overall morbidity was 38.88%. One patient died at 30 days of follow-up. The median follow-up time was 42.5 (IQR 19;65 months). The median pain reduction was 3 points according to the visual analog score. Six patients were diagnosed with malignant conditions after surgery (mean 27.8 ± 7.5 months). Wirsung’s duct size was statistically related with malignancy presentation after Frey’s procedure (Z = 2.54; P = 0.01).ConclusionAccording to our data, Frey’s procedure remains safe and feasible, with acceptable outcomes in terms of pain relief and pancreatic function. The study confirms the importance of a longstanding follow-up due to an inherent risk of pancreatic malignancy. Our data suggest that pancreatic duct size could be related with the malignancy diagnosis after Frey’s procedure; however, further prospective studies with a larger sample size would be helpful to confirm these results.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 1