Resection vs drainage in treatment of chronic pancreatitis: long-term results of a randomized trial.
OBJECTIVE
Tailored organ-sparing procedures have been shown to alleviate pain and are potentially superior in terms of preservation of endocrine and exocrine function as compared with standard resection (Whipple) for chronic pancreatitis with inflammatory pancreatic head tumor. Long-term results comparing these 2 procedures have not been published so far. The aim of this study was to report on long-term results of a randomized trial comparing a classical resective procedure (pylorus-preserving Whipple) with an extended drainage procedure (Frey) for chronic pancreatitis.


METHODS
All patients who participated in a previously published randomized trial on the perioperative course comparing both procedures were contacted with a standardized, validated, quality of life and pain questionnaire. Additionally, patients were seen in the outpatient clinic to assess endocrine and exocrine pancreatic function by an oral glucose tolerance test and fecal chymotrypsin test.


RESULTS
There were no differences between both groups regarding quality of life, pain control, or other somatic parameters after a median of 7 years postoperatively. Correlations among continuous alcohol consumption, endocrine or exocrine pancreatic function, and pain were not found.


CONCLUSIONS
Both procedures provide adequate pain relief and quality of life after long-term follow-up with no differences regarding exocrine and endocrine function. However, short-term results favor the organ-sparing procedure.
Strate
Tim
T
Department of General Surgery, University Hospital Hamburg Eppendorf, Hamburg, Germany. strate@uke.uni-hamburg.de
Bachmann
Kai
K
Busch
Philipp
P
Mann
Oliver
O
Schneider
Claus
C
Bruhn
Jens P
JP
Yekebas
Emre
E
Kuechler
Thomas
T
Bloechle
Christian
C
Izbicki
Jakob R
JR
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002918:Chymotrypsin / Q000378:metabolism; D004322:Drainage / Q000379:methods*; D005243:Feces / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D002918:Chymotrypsin