title: Frey's pancreaticojejunostomy in tropical pancreatitis: assessment of quality of life. A prospective study.
abstract: BACKGROUND
  Tropical pancreatitis is a form of chronic pancreatitis originally described in the tropics. Prospective studies in Western countries have shown improved quality of life (QOL) following surgery in alcoholic chronic pancreatitis. In studies on Frey's pancreaticojejunostomy for tropical pancreatitis, improvement in pain was considered the endpoint, and there is a paucity of data in the literature with regard to QOL with tropical pancreatitis following surgery.
  
  
  OBJECTIVE
  Our objective was to prospectively analyze the outcome of Frey's pancreaticojejunostomy in tropical pancreatitis and health-related QOL following surgery by administering the Short Form 36-item health survey (SF-36).
  
  
  METHODS
  A total of 25 patients underwent Frey's pancreaticojejunostomy between 2010 and 2012 and were included in the study; data were collected prospectively. The visual analog scale (VAS) for pain and the SF-36 form were used to record health-related QOL preoperatively, and at 3 and 12 months post-surgery, comparing the same with the general population.
  
  
  RESULTS
  Patients with tropical pancreatitis experience poor QOL (26.71 ± 15.95) compared with the general population (84.54 ± 12.42). Post-operative QOL scores (78.54 ± 15.84) were better than the pre-operative scores (26.71 ± 15.95) at 12-month post-surgery follow-up. The VAS score for pain improved at 12 months post-surgery (1.58 ± 1.41 vs. 8.21 ± 1.64). Two of the three patients (12.5 %) who had diabetes were free from anti-diabetes medication at 12 months post-surgery. Steatorrhea was seen in five patients (20.8 %) before surgery and increased to eight (33.3 %) at 12 months post-surgery. Mean body weight increased from 45.75 kg pre-operatively to 49.25 kg at 12 months post-operatively.
  
  
  CONCLUSIONS
  Frey's pancreaticojejunostomy effectively reduces pain in tropical pancreatitis, with significant improvement in health-related QOL, which is comparable with the general population in most aspects.
authors.affiliation: Department of Surgical Gastroenterology, Narayana Medical College, Nellore, Andhra Pradesh, India, drvamsipr1@gmail.com.
authors.forename: Vamsi Krishna
authors.initials: VK
authors.lastname: Pothula Rajendra
authors.forename: Sivaraj
authors.initials: S
authors.lastname: Sivanpillay Mahadevan
authors.forename: Sivacharan Reddy
authors.initials: SR
authors.lastname: Parvathareddy
authors.forename: Bharat Kumar
authors.initials: BK
authors.lastname: Nara
authors.forename: Mallikarjuna
authors.initials: M
authors.lastname: Gorlagunta Ramachandra
authors.forename: Aditya Chowdary
authors.initials: AC
authors.lastname: Tripuraneni Venkata
authors.forename: Jagan Mohan Reddy
authors.initials: JM
authors.lastname: Bathalapalli
authors.forename: Vara Prasada Rao
authors.initials: VP
authors.lastname: Gudi
authors.forename: Thirunavukkarasu
authors.initials: T
authors.lastname: Sampath
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010193:Pancreaticojejunostomy / Q000379:methods*; D019512:Pancreatitis, Alcoholic / Q000150:complications / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D045602:Steatorrhea / Q000209:etiology; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult