title: How much of the pancreatic head should we resect in Frey's procedure?
abstract: OBJECTIVE
  Frey's procedure for chronic pancreatitis (CP) has been minimized gradually in our institution in recent years. We compared the functional outcome of minimized Frey's procedure with that of modified Frey's procedure to establish how deeply and widely we should cut into the head of the pancreas.
  
  
  METHODS
  Between January 1992 and December 2006, we performed Frey's procedure on 57 patients; as modi-fied Frey's procedure from 1992 to 2001, then as minimized Frey's procedure from 2002 to 2006. The patients' pre- and postoperative pain scores (PS), rates of readmission, body mass indexes (BMI), plasma glucose levels (PG), hemoglobin A1c, daily insulin use (DIU), and pancreatic function diagnostant were systematically reviewed and compared between the two groups.
  
  
  RESULTS
  Frey's procedure resulted in a significant decrease in PS (P < 0.001) and a significant increase in BMI (P = 0.01). There were no significant differences in the pre- and postoperative PG or DIU. The outcome of the late group was similar to that of the early group in terms of pain relief and preservation of endocrine function. There was no early postoperative mortality.
  
  
  CONCLUSIONS
  These findings suggest that minimum Frey's procedure is sufficient for resolving intractable pain and improving nutritional status in most patients with CP.
authors.affiliation: Division of Hepato-Biliary Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Sakata
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Goto
authors.forename: Seiki
authors.initials: S
authors.lastname: Matsuno
authors.forename: Yu
authors.initials: Y
authors.lastname: Katayose
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D050500:Pancreatitis, Chronic / Q000601:surgery*; D010359:Patient Readmission / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human