Long-term follow-up of a randomized trial comparing the beger and frey procedures for patients suffering from chronic pancreatitis.
OBJECTIVE
To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis.


BACKGROUND
Resection and drainage are the 2 basic surgical principles in surgical treatment of chronic pancreatitis. They are combined to various degrees by the classic duodenum preserving pancreatic head resection (Beger) and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy (Frey). These procedures have been evaluated in a randomized controlled trial by our group. Long-term follow up has not been reported so far.


METHODS
Seventy-four patients suffering from chronic pancreatitis were initially allocated to DPHR (n = 38) or LE (n = 36). This postoperative follow-up included the following parameters: mortality, quality of life (QL), pain (validated pain score), and exocrine and endocrine function.


RESULTS
Median follow-up was 104 months (72-144). Seven patients were not available for follow-up (Beger = 4; Frey = 3). There was no significant difference in late mortality (31% [8/26] versus 32% [8/25]). No significant differences were found regarding QL (global QL 66.7 [0-100] versus 58.35 [0-100]), pain score (11.25 [0-75] versus 11.25 [0-99.75]), exocrine (88% versus 78%) or endocrine insufficiency (56% versus 60%).


CONCLUSIONS
After almost 9 years' long-term follow-up, there was no difference regarding mortality, quality of life, pain, or exocrine or endocrine insufficiency within the 2 groups. The decision which procedure to choose should be based on the surgeon's experience.
Strate
Tim
T
Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany.
Taherpour
Zohre
Z
Bloechle
Christian
C
Mann
Oliver
O
Bruhn
Jens P
JP
Schneider
Claus
C
Kuechler
Thomas
T
Yekebas
Emre
E
Izbicki
Jakob R
JR
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010186:Pancreatic Function Tests; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D010195:Pancreatitis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017060:Patient Satisfaction; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome