Factors affecting outcome after Frey procedure for chronic pancreatitis.
BACKGROUND
Debilitating abdominal pain remains the most common presentation of chronic pancreatitis and the treatment remains challenging.


OBJECTIVE
This prospective study analyzed the outcome of Frey's procedure in patients with inflammatory head mass.


METHODS
For the period between 2002 and 2007, 77 patients with chronic pancreatitis underwent Frey procedure for intractable abdominal pain. The mean follow-up was 14 months. For the purpose of analysis of the outcome, patients were grouped as poor pain control (19%) and good pain control groups (81%) based on the pain scores during follow-up.


RESULTS
There was no 30-day mortality. The logistic regression analysis showed that decreased volume percentage (48%) of head mass resected (p=0.003) and small diameter of the pancreatic duct (p=0.05) were associated with poor pain outcome. Subgroup analysis revealed that patients with small duct disease were associated with increased operative time (p=0.001), poor pain scores (p=0.001), and increased weight loss (p=0.003) during follow-up.


CONCLUSIONS
Frey procedure can be performed with zero mortality and low morbidity in a high-volume center. It provides good pain relief in majority of the patients. Volume of the head mass cored affects pain outcome. Correlation between poor results in terms of pain relief and weight loss following Frey's procedure, and small duct disease supports the view that duct diameter is an important predictor of pain relief.
Amudhan
Anbalagan
A
Department of Surgical Gastroenterology, Centre for GI bleed & Division of hepato biliary pancreatic diseases, Government Stanley Medical College Hospital, Chennai, TN, India. amudhanmch@yahoo.co.in
Balachandar
Tirupporur Govindaswamy
TG
Kannan
Devy Gounder
DG
Rajarathinam
Govindhasamy
G
Vimalraj
Vellayudham
V
Rajendran
Shanmugasundaram
S
Ravichandran
Palanisamy
P
Jeswanth
Satyanesan
S
Surendran
Rajagopal
R