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Short- and long-term outcomes of the Frey procedure for chronic pancreatitis: a single-center experience and summary of outcomes in Japan

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Abstract

Purpose

To evaluate the short- and long-term outcomes of the Frey procedure for chronic pancreatitis (CP).

Methods

The subjects of this study were 12 patients who underwent the Frey procedure for CP between January, 2000 and December, 2016. We assessed pain relief, weight gain, and exocrine/endocrine insufficiency during follow-up.

Results

The study population comprised 11 men and 1 woman (91.7% vs. 8.3%; mean age, 50.3 ± 6.8 years; range 39–61 years). Pancreatitis was caused by alcohol in 9 (75%) patients and was idiopathic in 3 (25%) patients. The mean follow-up period was 82.5 ± 46.5 months (range 16.9–152.1 months). There was no operative mortality, but three patients (25%) suffered postoperative morbidity. All patients were pain-free at the time of discharge. There was no case of new-onset diabetes mellitus after surgery, although one patient (8.3%) suffered exocrine insufficiency. The body weight and body mass index of all patients improved during follow-up. Only one patient continued to suffer pain in the long term.

Conclusion

The findings of this long-term follow-up of patients who underwent the Frey procedure suggest that it offers effective pain relief and is a safe technique for the management of CP.

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References

  1. Büchler MW, Friess H, Müller MW, Wheatley AM, Beger HG. Randomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis. Am J Surg. 1995;169:65–9.

    Article  PubMed  Google Scholar 

  2. Klempa I, Spatny M, Menzel J, Baca I, Nustede R, Stöckmann F, et al. Pancreatic function and quality of life after resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized comparative study after duodenum preserving resection of the head of the pancreas versus Whipple’s operation. Chirurg. 1995;66:350–9.

    CAS  PubMed  Google Scholar 

  3. Izbicki JR, Bloechle C, Broering DC, Knoefel WT, Kuechler T, Broelsch CE. Extended drainage versus resection surgery for chronic pancreatitis: a prospective randomized trial comparing the longitudinal pancreaticojejunostomy combined with local pancreatic head excision with pylorus-preserving pancreatoduodenectomy. Ann Surg. 1998;228:771–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas. 1987;2:701–7.

    Article  CAS  PubMed  Google Scholar 

  5. Rault A, SaCunha A, Klopfenstein D, Larroudé D, Epoy FN, Collet D, et al. Pancreaticojejunal anastomosis is preferable to pancreaticogastrostomy after pancreaticoduodenectomy for long term outcomes of pancreatic exocrine function. J Am Coll Surg. 2005;201:239–44.

    Article  PubMed  Google Scholar 

  6. Cancer pain relief guidelines. The WHO analgesic ladder. 1st ed. Geneva: World Health Organization; 1986.

  7. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.

    Article  PubMed  Google Scholar 

  8. Traverso LW, Kozarek RA. Pancreatoduodenectomy for chronic pancreatitis: anatomic selection criteria and subsequent long-term outcome analysis. Ann Surg. 1997;226:429–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Forssmann K, Schirr K, Schmid M, Schwall G, Silbernik D, Singer M, et al. Postoperative follow-up in patients with partial Whipple duodenopancreatectomy for chronic pancreatitis. Z Gastroenterol. 1997;35:1071–80.

    CAS  PubMed  Google Scholar 

  10. Müller MW, Friess H, Beger HG, Kleeff J, Lauterburg B, Glasbrenner B, et al. Gastric emptying following pylorus-preserving Whipple and duodenum-preserving pancreatic head resection in patients with chronic pancreatitis. Am J Surg. 1997;173:257–63.

    Article  PubMed  Google Scholar 

  11. Frey CF, Mayer KL. Comparison of local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure) and duodenum-preserving resection of the pancreatic head (Beger procedure). World J Surg. 2003;27:1217–30.

    Article  PubMed  Google Scholar 

  12. Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis; a prospective randomized trial. Ann Surg. 1995;221:350–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Chaudhary A, Negi SS, Massod S, Thombare M. Complications after Frey’s procedure for chronic pancreatitis. Am J Surg. 2004;188:277–81.

    Article  PubMed  Google Scholar 

  14. Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.

    Article  PubMed  Google Scholar 

  15. Pessaux P, Kianmanesh R, Regimbeau JM, Sastre B, Delcenserie R, Sielezneff I. Frey procedure in the treatment of chronic pancreatitis short-term results. Pancreas. 2006;33:354–8.

    Article  PubMed  Google Scholar 

  16. Ueda J, Miyasaka Y, Ohtsuka T, Takahata S, Tanaka M. Short- and long-term results of the Frey procedure for chronic pancreatitis. J Hepatobiliary Pancreat Sci. 2015;22:211–6.

    Article  PubMed  Google Scholar 

  17. Egawa S, Motoi F, Sakata N, Kitamura Y, Nakagawa K, Ohtsuka H, et al. Assessment of Frey procedures: Japanese experience. J Hepatobiliary Pancreat Sci. 2010;17:745–51.

    Article  PubMed  Google Scholar 

  18. Roch AM, Brachet D, Lermite E, Pessaux P, Arnaud JP. Frey procedure in patients with chronic pancreatitis: short and long-term outcome from a prospective study. J Gastrointest Surg. 2012;16:1362–9.

    Article  PubMed  Google Scholar 

  19. Strate T, Taherpour Z, Bloechle C, Mann O, Bruhn JP, Schneider C. Long-term follow-up of a randomized trial comparing the Beger and Frey procedures for patients suffering from chronic pancreatitis. Ann Surg. 2005;241:591–8.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Amikura K, Arai K, Kobari M, Matsuno S. Surgery for chronic pancreatitis—extended pancreaticojejunostomy. Hepatogastroenterology. 1997;44:1547–53.

    CAS  PubMed  Google Scholar 

  21. Aimoto T, Uchida E, Matsushita A, Kawano Y, Mizutani S, Kobayashi T. Long-term outcomes after Frey’s procedure for chronic pancreatitis with an inflammatory mass of the pancreatic head, with special reference to locoregional complications. J Nippon Med Sch. 2013;80:148–54.

    Article  PubMed  Google Scholar 

  22. Tanaka M, Matsumoto I, Shinzeki M, Asari S, Goto T, Yamashita H, et al. Short- and long-term results of modified Frey’s procedure in patients with chronic pancreatitis: a retrospective Japanese single-center study. Kobe J Med Sci. 2014;60:E30–6.

    PubMed  Google Scholar 

  23. Zhou Y, Shi B, Wu L, Wu X, Li Y. Frey procedure for chronic pancreatitis: evidence-based assessment of short- and long-term results in comparison to pancreatoduodenectomy and Beger procedure: a meta-analysis. Pancreatology. 2015;15:372–9.

    Article  PubMed  Google Scholar 

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Correspondence to Etsuro Hatano.

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We declare no conflict of interest in association with the present study.

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Suzumura, K., Hatano, E., Okada, T. et al. Short- and long-term outcomes of the Frey procedure for chronic pancreatitis: a single-center experience and summary of outcomes in Japan. Surg Today 48, 58–65 (2018). https://doi.org/10.1007/s00595-017-1548-0

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  • DOI: https://doi.org/10.1007/s00595-017-1548-0

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