How much of the pancreatic head should we resect in Frey's procedure?
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.
Sakata
Naoaki
N
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.
Egawa
Shinichi
S
Motoi
Fuyuhiko
F
Goto
Masafumi
M
Matsuno
Seiki
S
Katayose
Yu
Y
Unno
Michiaki
M
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
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human