Abstract
The etiology of pain in chronic pancreatitis may be ductal hypertension, increased parenchymal pressure, or neural damage. It is difficult to assess the severity of pain in this patient population, a problem made more challenging by the frequency of narcotic dependency. Therapeutic interventions developed to relieve the pain of chronic pancreatitis include denervation of the pancreas, decompression of the main duct of the pancreas, resection of part or all of the diseased pancreas, and reduction of pancreatic secretion. Operative intervention for patients with chronic pain is indicated when severe pain, complications of pain, or potential malignancy are present. The operations that consistently provide long-lasting pain relief all have in common resection of all or a portion of the head of the pancreas. Adverse effects on exocrine and endocrine function, nutrition, and quality of life are related to the amount of pancreas resected. The ideal procedure should be easy to perform, have a low morbidity and mortality rate, provide long-lasting pain relief, and not augment endocrine and exocrine insufficiency. No single operation fulfills this ideal. The local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (LR-LPJ) proposed by Frey and the duodenum-preserving resection of the head of the pancreas (DPHR) proposed by Beger are discussed. The conceptualization, development, and technique of LR-LPJ are discussed, and comparisons of patient outcomes are made with the outcomes of other procedures for chronic pancreatitis.
Similar content being viewed by others
References
ND Karanjia AL Widdison FW Leung et al. (1994) ArticleTitleCompartment syndrome in experimental chronic obstructive pancreatitis: effect of decompressing the main pancreatic duct Br. J. Surg. 81 259–264 Occurrence Handle1:STN:280:ByuB3cjnsFQ%3D Occurrence Handle8156353
CF Frey K Amikura (1994) ArticleTitleLocal resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy in the management of patients with chronic pancreatitis Ann. Surg. 220 492–504 Occurrence Handle1:STN:280:ByqD3s7jsVw%3D Occurrence Handle7524454
EL Bradley Suffix3rd (1982) ArticleTitlePancreatic duct pressure in chronic pancreatitis Am. J. Surg. 144 313–316 Occurrence Handle7114368
CF Frey (1973) 95% pancreatectomy LC Carey (Eds) The Pancreas Mosby Year Book St. Louis 202–229
DE Bockman M Buchler P Malfertheiner et al. (1988) ArticleTitleAnalysis of nerves in chronic pancreatitis Gastroenterology 94 1459–1469
AL Widdison C Alvarez ND Karanjia et al. (1991) ArticleTitleExperimental evidence of beneficial effects of ductal decompression in chronic pancreatitis Endoscopy 23 151–154 Occurrence Handle1:STN:280:By6A3MjhsFM%3D Occurrence Handle1860444
E Weihe M Büchler S Müller et al. (1990) Peptidergic innervation in chronic pancreatitis HG Beger M Buchler H Ditschuneit et al (Eds) Chronic Pancreatitis Springer-Verlag Berlin 83–105
R Amman (2001) ArticleTitleThe natural history of alcoholic chronic pancreatitis Ann. Intern. Med. 40 368–375
DM Proca EC Ellison D Hibbert et al. (2001) ArticleTitleMajor pancreatic resections for chronic pancreatitis Arch. Pathol. Lab. Med. 125 1051–1054 Occurrence Handle1:STN:280:DC%2BD3Mvltlahuw%3D%3D Occurrence Handle11473456
IP Linehan MA Lambert DC Brown et al. (1988) ArticleTitleTotal pancreatectomy for chronic pancreatitis Gut 29 358–365 Occurrence Handle1:STN:280:BieC1crovVc%3D Occurrence Handle3356368
A Mannell MA Adson DC McIlrath et al. (1988) ArticleTitleSurgical management of chronic pancreatitis: long-term results in 141 patients Br. J. Surg. 75 467–472 Occurrence Handle1:STN:280:BieB28bpvVc%3D Occurrence Handle3390681
JW Braasch L Vito FW Nugent (1978) ArticleTitleTotal pancreatectomy of end-stage chronic pancreatitis Ann. Surg. 188 317–322 Occurrence Handle1:STN:280:CSeB2Mrot1U%3D Occurrence Handle686897
CF Frey CG Child WF Fry (1976) ArticleTitlePancreatectomy for chronic pancreatitis Ann. Surg. 184 403–414 Occurrence Handle1:STN:280:CSiC3M%2Fos1A%3D Occurrence Handle1015887
HG Beger W Krautzberger R Bittner et al. (1985) ArticleTitleDuodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis Surgery 97 467–473 Occurrence Handle1:STN:280:BiqC28fnsFM%3D Occurrence Handle3983823
FP Gall C Gebhardt H Zirngibl (1982) ArticleTitleChronic pancreatitis -- results of 116 consecutive, partial duodenopancreatectomy combined with pancreatic duct occlusion Hepatogastroenterology. 29 115–119 Occurrence Handle1:STN:280:Bi2B28zisFY%3D Occurrence Handle7106696
LW Traverso RA Kozarek (1993) ArticleTitleThe Whipple procedure for severe complications of chronic pancreatitis Arch. Surg. 128 1047–1053 Occurrence Handle1:STN:280:ByyA2sfltlM%3D Occurrence Handle8368923
FP Gall C Gebhardt R Meister et al. (1989) ArticleTitleSevere chronic cephalic pancreatitis: use of partial duodenopancreatectomy with occlusion of the pancreatic duct in 289 patients World J. Surg. 13 809–817 Occurrence Handle1:STN:280:By%2BC28zkt1I%3D Occurrence Handle2623892
MJ Cooper RC Williamson IS Benjamin et al. (1987) ArticleTitleTotal pancreatectomy for chronic pancreatitis Br. J. Surg. 74 912–915 Occurrence Handle1:STN:280:BieD38ngslE%3D Occurrence Handle3664222
S Miyakawa M Hayakawa A Horiguchi et al. (1996) ArticleTitleEstimation of fat absorption with the 13C-trioctanoin breath test after pancreatoduodenectomy or pancreatic head resection World J. Surg. 20 1024–1028 Occurrence Handle10.1007/s002689900156 Occurrence Handle1:STN:280:BymA1MvntVI%3D Occurrence Handle8798360
RP Kerremans FM Penninckx J Groote ParticleDe et al. (1987) ArticleTitleSubtotal resection of the head of the pancreas combined with ductal obliteration of the distal pancreas in chronic pancreatitis Ann. Surg. 205 240–245 Occurrence Handle1:STN:280:BiiC2Mrlt10%3D Occurrence Handle3827358
MS Woods LW Traverso RA Kozarek et al. (1995) ArticleTitleSuccessful treatment of bleeding pseudoaneurysms of chronic pancreatitis Pancreas 10 22–30 Occurrence Handle1:STN:280:ByqB3cjjsFQ%3D Occurrence Handle7899456
WM Stone MG Sarr DM Nagorney et al. (1998) ArticleTitleChronic pancreatitis. Results of Whipple’s resection and total pancreatectomy Arch. Surg. 123 815–819
JM Howard Z Zhang (1990) ArticleTitlePancreaticoduodenectomy (Whipple resection) in the treatment of chronic pancreatitis World J. Surg. 14 77–82 Occurrence Handle1:STN:280:By%2BC28zksVM%3D Occurrence Handle2305589
WH Nealon CM Townsend SuffixJr JC Thompson (1988) ArticleTitleOperative drainage of the pancreatic duct delays functional impairment in patients with chronic pancreatitis. A prospective analysis Ann. Surg. 208 321–329 Occurrence Handle1:STN:280:BieA3sbkt1E%3D Occurrence Handle3421756
RA Prinz HB Greenlee (1990) ArticleTitlePancreatic duct drainage in chronic pancreatitis Hepatogastroenterology. 37 295–300 Occurrence Handle1:STN:280:By%2BA38zns1A%3D Occurrence Handle1695604
A Escallon SuffixJr JS Aldrete (1986) ArticleTitleLateral pancreaticojejunostomy for pain relief in chronic pancreatitis: analysis of effectiveness in 19 patients South. Med. J. 79 936–940 Occurrence Handle2426795
DH Drake WJ Fry (1989) ArticleTitleDuctal drainage for chronic pancreatitis Surgery 105 131–140 Occurrence Handle1:STN:280:BiaC3s%2FjsVw%3D Occurrence Handle2916177
MW Buchler H Friess R Bittoner et al. (1997) ArticleTitleDuodenum-preserving pancreatic head resection: long-term results J. Gastrointest. Surg. 1 13–19 Occurrence Handle10.1016/S1091-255X(97)80004-2 Occurrence Handle9834325
CF Frey (1998) ArticleTitleThe surgical management of chronic pancreatitis: the Frey procedure Adv. Surg. 32 41–85
CE Morrow JI Cohen DE Sutherland et al. (1984) ArticleTitleChronic pancreatitis: long-term surgical results of pancreatic duct drainage, pancreatic resection, and near-total pancreatectomy and islet autotransplantation Surgery 96 608–616 Occurrence Handle1:STN:280:BiqD3MjhtFw%3D Occurrence Handle6435270
FE Eckhauser WE Strodel JA Knol et al. (1984) ArticleTitleNear-total pancreatectomy for chronic pancreatitis Surgery 96 599–607 Occurrence Handle1:STN:280:BiqD3MjhtFM%3D Occurrence Handle6484804
FP Gall H Zirngibl C Gebhardt et al. (1990) ArticleTitleduodenal pancreatectomy with occlusion of the pancreatic duct Hepatogastroenterology. 37 290–294 Occurrence Handle1:STN:280:By%2BA38zns1c%3D Occurrence Handle2373461
JA Pain MJ Knight (1988) ArticleTitlePancreaticogastrostomy: the preferred operation for pain relief in chronic pancreatitis Br. J. Surg. 75 220–222 Occurrence Handle1:STN:280:BieC28vislw%3D Occurrence Handle3349329
JR Izbicki C Bloechle DC Broering et al. (1998) ArticleTitleExtended drainage versus resection in surgery for chronic pancreatitis. A prospective randomized trial comparing the longitudinal pancreaticojejunostomy combined with local pancreatic head excision with the pylorus-preserving pancreatoduodenectomy Ann. Surg. 228 771–779 Occurrence Handle10.1097/00000658-199812000-00008 Occurrence Handle1:STN:280:DyaK1M%2FnsFyiuw%3D%3D Occurrence Handle9860476
PF Partington RL Rochelle (1960) ArticleTitleModified Puestow procedure for retrograde drainage of the pancreatic duct Ann. Surg. 152 1037–1043 Occurrence Handle1:STN:280:CC%2BD2M3mvVY%3D Occurrence Handle13733040
M Adolff M Schloegel JP Arnaud et al. (1991) ArticleTitleRole of pancreatojejunostomy in the treatment of chronic pancreatitis. A study of 105 operated patients Chirurgie 117 251–256 Occurrence Handle1817818
TG Wilson MJ Hollands JM Little (1992) ArticleTitlePancreaticojejunostomy for chronic pancreatitis Aust. N. Z. J. Surg. 62 111–115 Occurrence Handle1:STN:280:By2B28vpt1A%3D Occurrence Handle1586299
RH Taylor FH Bagley JW Braasch et al. (1981) ArticleTitleDuctal drainage or resection for chronic pancreatitis Am. J. Surg. 141 28–33 Occurrence Handle1:STN:280:Bi6C3cjht1I%3D Occurrence Handle7457724
EL Bradley Suffix3rd (1987) ArticleTitleLong-term results of pancreatojejunostomy in patients with chronic pancreatitis Am. J. Surg. 153 207–217 Occurrence Handle3812895
L Leger JP Lenriot G Lemaigri (1974) ArticleTitleFive to twenty year followup after surgery for chronic pancreatitis in 148 patients Ann. Surg. 180 185–192 Occurrence Handle1:STN:280:CSuB2snovFA%3D Occurrence Handle4842980
JT Holmberg G Isaksson I Ihse (1985) ArticleTitleLong term results of pancreaticojejunostomy in chronic pancreatitis Surg. Gynecol. Obstet. 160 339–346 Occurrence Handle1:STN:280:BiqC28fntFQ%3D Occurrence Handle2580360
MK DuVal (1954) ArticleTitleCaudal pancreatico-jejunostomy for chronic relapsing pancreatitis Ann. Surg. 140 775–785 Occurrence Handle13208131
H Doubilet JH Mulholland (1951) ArticleTitleThe surgical treatment of acute pancreatitis by endocholedochal sphincterotomy Surg. Gynecol. Obstet. 86 295
EL Bradley Suffix3rd JA Reynhout GL Peer (1998) ArticleTitleThoracoscopic splanchnicectomy for “small duct” chronic pancreatitis: case selection by differential epidural analgesia J. Gastrointest. Surg. 2 88–94 Occurrence Handle10.1016/S1091-255X(98)80108-X Occurrence Handle9841973
JW Maher FC Johlin D Pearson (1996) ArticleTitleThoracoscopic splanchnicectomy for chronic pancreatitis pain Surgery 120 603–610 Occurrence Handle1:STN:280:ByiD3MrntF0%3D Occurrence Handle8862367
I Ihse E Zoucas E Gyllstedt et al. (1999) ArticleTitleBilateral thoracoscopic splanchnicectomy: effects on pancreatic pain and function Ann. Surg. 230 785–790 Occurrence Handle10.1097/00000658-199912000-00007 Occurrence Handle1:STN:280:DC%2BD3c%2FotFKkuw%3D%3D Occurrence Handle10615933
J Moodley B Singh AS Shaik et al. (1999) Thoracoscopic. World J. Surg. 23 608–692
TJ Howard JB Swofford et al. (2002) ArticleTitleQuality of life after bilateral thorascopic splanchnicectomy: long term evaluation in patients with chronic pancreatitis J. Gastrointest. Surg. 6 845–852 Occurrence Handle10.1016/S1091-255X(02)00123-3 Occurrence Handle12504223
A Malesci E Gaia A Floretta et al. (1995) ArticleTitleNo effect of long-term treatment with pancreatic extract on recurrent abdominal pain in patients with chronic pancreatitis Scand. J. Gastroenterol. 30 392–398 Occurrence Handle1:STN:280:ByqA3svmvFY%3D Occurrence Handle7610357
PP Toskes CE Forsmark MT DeMeo et al. (1997) ArticleTitleOctreotide for the pain of chronic pancreatitis: results of a multicenter, placebo-controlled, dose-ranging pilot study Pancreas 00 000–000
RG Keith FG Saibil RH Sheppard (1989) ArticleTitleTreatment of chronic alcoholic pancreatitis by pancreatic resection Am. J. Surg. 157 156–162 Occurrence Handle1:STN:280:BiaD1cnmtFE%3D Occurrence Handle2910121
I Klempa M Spatny J Menzel et al. (1995) ArticleTitlePancreatic function and quality of life after resection of the head of the pancreas in chronic pancreatitis. a prospective, randomized, comparative study of the duodenum preserving resection of the head of the pancreas versus Whipple’s operation Chirurg 66 350–359 Occurrence Handle1:STN:280:ByqA287msFQ%3D Occurrence Handle7634946
GA Rios DB Adams (2001) ArticleTitleDoes intraoperative electrohydraulic lithotripsy improve outcome in the surgical management of chronic pancreatitis? Am. Surg. 67 533–537 Occurrence Handle1:STN:280:DC%2BD3MzkslSntA%3D%3D Occurrence Handle11409800
C Chan M Vilatoba A Bartolucci et al. (2001) ArticleTitleImproved reduction in pain in chronic pancreatitis with combined intraoperative celiac axis plexus block and lateral pancreaticojejunostomy Curr. Surg. 58 220–222 Occurrence Handle10.1016/S0149-7944(00)00446-3 Occurrence Handle11275249
CC Frey (1998) ArticleTitleThe surgical management of chronic pancreatitis: the Frey Procedure Adv. Surg. 32 41–85
D Malka P Hammel A Sauvanet et al. (2000) ArticleTitleRisk factors for diabetes mellitus in chronic pancreatitis Gastroenterology 119 1324–1332 Occurrence Handle1:STN:280:DC%2BD3M%2Fkt1yrsw%3D%3D Occurrence Handle11054391
M Bourliere H Sarles (1989) ArticleTitlePancreatic cysts and pseudocysts associated with acute and chronic pancreatitis Dig. Dis. Sci. 34 343–348 Occurrence Handle1:STN:280:BiaC2M3ntVA%3D Occurrence Handle2646086
JL Cameron RS Kieffer WJ Anderson et al. (1976) ArticleTitleInternal pancreatic fistulas: pancreatic ascites and pleural effusions Ann. Surg. 184 587–593 Occurrence Handle1:STN:280:CSiD2cznt1M%3D Occurrence Handle984927
EW Pottmeyer SuffixIII CF Frey S Matsuno (1987) ArticleTitlePancreaticopleural fistulas Arch. Surg. 122 648–654 Occurrence Handle3579578
DW Weaver AJ Walt C Sugawa et al. (1982) ArticleTitleA continuing appraisal of pancreatic ascites Surg. Gynecol. Obstet. 154 845–848 Occurrence Handle1:STN:280:Bi2C1MbptFE%3D Occurrence Handle6177058
CF Frey (1993) The surgical treatment of chronic pancreatitis VLW Go EP DiMagno JD Gardner (Eds) The Pancreas: Biology, Pathobiology, and Disease EditionNumber2nd edition Raven Press New York 707–740
A Eickhoff R Jacobs A Leonhardt et al. (2001) ArticleTitleEndoscopic stenting for common bile duct stenoses in chronic pancreatitis: results and impact on long- term outcome Eur. J. Gastrointest. Hepatol. 13 1161–1167 Occurrence Handle10.1097/00042737-200110000-00007 Occurrence Handle1:STN:280:DC%2BD3MnmsVantQ%3D%3D
MJ Farnebecker et al. (2000) ArticleTitle. Am. J. Gastroenterol. 95 1466–1471 Occurrence Handle10.1016/S0002-9270(00)00870-4 Occurrence Handle10894580
W Schlosser B Poch HG Beger (2002) ArticleTitleDuodenum-preserving head resection leads to relief of common bile duct stenosis Am. J. Surg. 183 37–41 Occurrence Handle10.1016/S0002-9610(01)00713-9 Occurrence Handle11869700
CF Frey M Suzuki S Isaji (1990) ArticleTitleTreatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum World J. Surg. 14 59–69 Occurrence Handle1:STN:280:By%2BC28zksVE%3D Occurrence Handle2407039
J Yadegar RA Williams E Passaro SuffixJr et al. (1980) ArticleTitleCommon duct stricture from chronic pancreatitis Arch. Surg. 115 582 Occurrence Handle1:STN:280:Bi%2BC1MjivFU%3D Occurrence Handle7377960
BE Stabile R Calabria SE Wilson et al. (1987) ArticleTitleStricture of the common bile duct from chronic pancreatitis Surg. Gynecol. Obstet. 165 121–126 Occurrence Handle1:STN:280:BiiB28vgtVc%3D Occurrence Handle3603341
DW Rattner C Fernandez-del Castillo AL Warshaw (1996) ArticleTitlePitfalls of distal pancreatectomy for relief of pain in chronic pancreatitis Am. J. Surg. 171 142–146 Occurrence Handle10.1016/S0002-9610(99)80089-0 Occurrence Handle1:STN:280:BymC2c3htVY%3D Occurrence Handle8554129
TT White AH Slavotinek (1979) ArticleTitleResults of surgical treatment of chronic pancreatitis. Report of 142 cases Ann. Surg. 189 217–224 Occurrence Handle1:STN:280:CSaC2czosFU%3D Occurrence Handle426554
C L’Hermine G Lemaître JP Maillard et al. (1971) ArticleTitleSegmental portal hypertension in pancreatitis. Angiographic aspects Lille Med. 16 928–932 Occurrence Handle1:STN:280:CS2D3s%2FnsFU%3D Occurrence Handle5115738
MJ Hart H Miyashita TT White (1983) ArticleTitlePancreaticojejunostomy. Report of a 25 year experience Am. J. Surg. 145 567–570 Occurrence Handle1:STN:280:BiyB3c7otVA%3D Occurrence Handle6846692
JS Markowitz DW Rattner AL Warshaw (1994) ArticleTitleFailure of symptomatic relief after pancreaticojejunal decompression for chronic pancreatitis. Strategies for salvage Arch. Surg. 129 374–379 Occurrence Handle1:STN:280:ByuB3cnhvFQ%3D Occurrence Handle8154964
CE Lucas B McIntosh D Paley et al. (1999) ArticleTitleSurgical decompression of ductal obstruction in patients with chronic pancreatitis Surgery 126 790–795 Occurrence Handle10.1067/msy.2099.99954 Occurrence Handle1:STN:280:DyaK1MvkvFansg%3D%3D Occurrence Handle10520930
CP Frey HS Ho (1995) Chronic pancreatitis: Frey operation L Spitz AG Coran (Eds) Rob and Smith’s Operative Surgery Chapman and Hall London 497–503
CF Frey (1992) Partial and subtotal pancreatectomy for chronic pancreatitis LM Nyhus RJ Baker (Eds) Mastery of Surgery EditionNumber2nd edition, vol 2 Little, Brown and Company Boston 1029–1048
RH Bell SuffixJr (1996) Atlas of pancreatic surgery RH Bell LF Rikkers MW Mulholland, (Eds) Digestive Tract Surgery: A Text and Atlas Lippincott-Raven Philadelphia 963–115
HS Ho CF Frey (2001) ArticleTitleThe Frey procedure—local resection of pancreatic head combined with lateral pancreaticojejunostomy Arch. Surg. 136 1353–1358 Occurrence Handle10.1001/archsurg.136.12.1353 Occurrence Handle1:STN:280:DC%2BD38%2FivVyhsA%3D%3D Occurrence Handle11735858
CF Frey GJ Smith (1987) ArticleTitleDescription and rationale of a new operation for chronic pancreatitis Pancreas 2 701–707 Occurrence Handle1:STN:280:BieC2cvkt1M%3D Occurrence Handle3438308
CF Frey HA Pitt CJ Yeo et al. (1996) ArticleTitleA plea for uniform reporting of patient outcome in chronic pancreatitis Arch. Surg. 131 233–234 Occurrence Handle1:STN:280:BymC1MjptFw%3D Occurrence Handle8611085
JR Izbicki C Bloechle WT Knoefel et al. (1995) ArticleTitleDuodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial Ann. Surg. 221 350–358 Occurrence Handle1:STN:280:ByqB2cznsFM%3D Occurrence Handle7726670
LA Slezak DK Andersen (2001) ArticleTitlePancreatic resection: effects on glucose metabolism World J. Surg. 25 452–460 Occurrence Handle10.1007/s002680020337 Occurrence Handle1:STN:280:DC%2BD3M3kt1ertA%3D%3D Occurrence Handle11344398
D Malka P Hammel A Sauvanet et al. (2000) ArticleTitleRisk factors for diabetes mellitus in chronic pancreatitis Gastroenterology 119 1324–1332 Occurrence Handle1:STN:280:DC%2BD3M%2Fkt1yrsw%3D%3D Occurrence Handle11054391
L Gullo L Barbara G Labo (1988) ArticleTitleEffect of cessation of alcohol use on the course of pancreatic dysfunction in alcoholic pancreatitis Gastroenterology 95 1063–1068 Occurrence Handle1:STN:280:BieA3MzltVA%3D Occurrence Handle3410221
RW Ammann A Akovbiantz F Largiader et al. (1984) ArticleTitleCourse and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients Gastroenterology 86 820–828
T Berney T Rudisuhli J Oberholzer et al. (2000) ArticleTitleLong term metabolic results after pancreatic resection for severe chronic pancreatitis Arch. Surg. 135 1106–1111 Occurrence Handle10.1001/archsurg.135.9.1106 Occurrence Handle1:STN:280:DC%2BD3cvmtF2rsw%3D%3D Occurrence Handle10982519
P Massucco M Calgaro F Bertolino et al. (2001) ArticleTitleOutcome of surgical treatment for chronic calcifying pancreatitis Pancreas 4 378–382 Occurrence Handle10.1097/00006676-200105000-00007
P Aeberhard A Karli (1992) ArticleTitleThe Frey operation: a valuable enrichment of therapeutic possibilities of chronic calcifying pancreatitis Helv. Chir. Acta 58 633–636 Occurrence Handle1:STN:280:By2B2sngt10%3D Occurrence Handle1592627
P Morel A Rohner (1987) ArticleTitleSurgery for chronic pancreatitis Surgery 101 130–135 Occurrence Handle1:STN:280:BiiC38%2FotlI%3D Occurrence Handle3810483
RL Rossi (1990) ArticleTitlePancreatic resection for chronic pancreatitis Hepatogastroenterology. 37 277–282 Occurrence Handle1:STN:280:By%2BA38zns1U%3D Occurrence Handle2197205
A Carlin D Fromm (1993) ArticleTitlePancreaticoduodenectomy for recurrent alcoholic pancreatitis associated with microabscesses Surg. Gynecol. Obstet. 176 315–318 Occurrence Handle1:STN:280:ByyB3M3jtl0%3D Occurrence Handle8096346
WR Fleming RC Williamson (1995) ArticleTitleRole of total pancreatectomy in the treatment of patients with end-stage chronic pancreatitis Br. J. Surg. 82 1409–1412 Occurrence Handle1:STN:280:BymD1MjosVQ%3D Occurrence Handle7489180
L Fernandez-Cruz E Saenz E Astudillo et al. (1993) Comprehensive treatment: resection and drainage in the management of patients with chronic pancreatitis HG Beger M Buchler P Malfertheiner (Eds) Standards in Pancreatic Surgery Springer-Verlag New York 372–384
Russel C. Duodenum-preserving pancreatectomy. Presented at the Standards in Pancreatic Surgery meeting, Merseburg, Germany, July 1–4, 1991
CM Hoozen ParticleVan PG Peeke M Taubeneck et al. (1997) ArticleTitleEfficacy of enzyme supplementation after surgery for chronic pancreatitis Pancreas 14 174–180 Occurrence Handle9057190
WH Nealon JC Thompson (1993) ArticleTitleProgressive loss of pancreatic function in chronic pancreatitis is delayed by main pancreatic duct decompression Ann. Surg. 217 458–468 Occurrence Handle1:STN:280:ByyB2Mnmtlw%3D Occurrence Handle8489308
PG Lankisch A Lohr-Happe J Otto et al. (1993) ArticleTitleNatural course in chronic pancreatitis. Pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease Digestion 54 148–155 Occurrence Handle1:STN:280:ByyA28rpslM%3D Occurrence Handle8359556
P Layer H Yamamoto L Kalthoff et al. (1994) ArticleTitleThe different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis Gastroenterology 107 1481–1487
JR Izbicki C Bloechle WT Knoefel et al. (1997) ArticleTitleDrainage versus resection in surgical therapy of chronic pancreatitis of the head of the pancreas: a randomized study Chirurg 68 369–377 Occurrence Handle1:STN:280:ByiB2sjpt1A%3D
MW Buchler H Friess MW Muller et al. (1995) ArticleTitleRandomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis Am. J. Surg. 169 65–69 Occurrence Handle10.1016/S0002-9610(99)80111-1 Occurrence Handle1:STN:280:ByqC3Mjns1c%3D Occurrence Handle7818000
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Frey, C., Mayer, K. 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. 27, 1217–1230 (2003). https://doi.org/10.1007/s00268-003-7241-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-003-7241-z