title: Resection vs drainage in treatment of chronic pancreatitis: long-term results of a randomized trial.
abstract: 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.
authors.affiliation: Department of General Surgery, University Hospital Hamburg Eppendorf, Hamburg, Germany. strate@uke.uni-hamburg.de
authors.forename: Tim
authors.initials: T
authors.lastname: Strate
authors.forename: Kai
authors.initials: K
authors.lastname: Bachmann
authors.forename: Philipp
authors.initials: P
authors.lastname: Busch
authors.forename: Oliver
authors.initials: O
authors.lastname: Mann
authors.forename: Claus
authors.initials: C
authors.lastname: Schneider
authors.forename: Jens P
authors.initials: JP
authors.lastname: Bruhn
authors.forename: Emre
authors.initials: E
authors.lastname: Yekebas
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuechler
authors.forename: Christian
authors.initials: C
authors.lastname: Bloechle
authors.forename: Jakob R
authors.initials: JR
authors.lastname: Izbicki
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D002918:Chymotrypsin