Pancreaticoduodenectomy versus Frey's procedure for chronic pancreatitis: preliminary data on outcome and pancreatic function.
OBJECTIVE
Several surgical treatments have been proposed for treating chronic pancreatitis (CP), including standard pancreaticoduodenectomy (PD), pylorus-preserving PD, Beger's procedure, and Frey's procedure; however, few studies have compared pre- and postoperative pancreatic function in patients undergoing surgery for CP.


METHODS
Between 1996 and 2003, 42 patients with CP underwent pancreatic head resection; as PD in 17 and as Frey's procedure in 25. Frey's procedure was chosen if the pancreatic duct was dilated more than 5 mm. We conducted this prospective, nonrandomized study to compare the pre- and postoperative status after PD or Frey's procedure by evaluating pancreatic function and symptom relief.


RESULTS
The demographic features, surgical morbidity, and mortality were similar in the two groups. Pancreatic exocrine function improved, pain subsided, and complications of the adjacent organs resolved after surgery in both groups. Similar postoperative endocrine and exocrine functional results were observed in both groups. Frey's procedure was associated with a significantly shorter hospital stay than PD (10.6 versus 15.4 days, respectively; (P < 0.0001)).


CONCLUSIONS
There were no significant difference in operative time, surgical morbidity, or mortality rates between PD and Frey's procedure. Both procedures were equally effective in terms of pain relief, improvement of pancreatic exocrine function, and control of complications affecting the adjacent organs; however, Frey's procedure was associated with a significantly shorter hospital stay.
Chiang
Kun-Chun
KC
Department of General Surgery, Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan.
Yeh
Chun-Nan
CN
Hsu
Jun-Te
JT
Chen
Han-Ming
HM
Chen
Huang-Yang
HY
Hwang
Tsann-Long
TL
Jan
Yi-Yin
YY
Chen
Miin-Fu
MF
D010129:4-Aminobenzoic Acid; D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance; D005243:Feces / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007202:Indicators and Reagents / Q000494:pharmacology; D008297:Male; D010179:Pancreas / Q000378:metabolism*; D010196:Pancreatic Elastase / Q000378:metabolism; D010186:Pancreatic Function Tests / Q000379:methods; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D062366:para-Aminobenzoates
D007202:Indicators and Reagents; D062366:para-Aminobenzoates; C006717:bentiromide; D010196:Pancreatic Elastase; D010129:4-Aminobenzoic Acid