Abstract
Purpose
Several surgical treatments have been proposed for treating chronic pancreatitis (CP), including standard pancreaticoduodenectomy (PD), pylorus-preserving PD, Beger's procedure, and Frey's procedure; however, few studies have compared pre- and postoperative pancreatic function in patients undergoing surgery for CP.
Methods
Between 1996 and 2003, 42 patients with CP underwent pancreatic head resection; as PD in 17 and as Frey's procedure in 25. Frey's procedure was chosen if the pancreatic duct was dilated more than 5 mm. We conducted this prospective, nonrandomized study to compare the pre- and postoperative status after PD or Frey's procedure by evaluating pancreatic function and symptom relief.
Results
The demographic features, surgical morbidity, and mortality were similar in the two groups. Pancreatic exocrine function improved, pain subsided, and complications of the adjacent organs resolved after surgery in both groups. Similar postoperative endocrine and exocrine functional results were observed in both groups. Frey's procedure was associated with a significantly shorter hospital stay than PD (10.6 versus 15.4 days, respectively; (P < 0.0001)).
Conclusion
There were no significant difference in operative time, surgical morbidity, or mortality rates between PD and Frey's procedure. Both procedures were equally effective in terms of pain relief, improvement of pancreatic exocrine function, and control of complications affecting the adjacent organs; however, Frey's procedure was associated with a significantly shorter hospital stay.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
HG Beger W Krautzberger R Bittner M Büchler J Limmer (1985) ArticleTitleDuodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis Surgery 98 467–73
HG Beger M Büchler R Bittner W Oettinger R Roscher (1989) ArticleTitleDuodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis Ann Surg 209 123–8 Occurrence Handle10.1097/00000658-198903000-00004
HM Chen YY Jan TC Chao TL Hwang MF Chen (2003) ArticleTitlePancreatodudenectomy for chronic pancreatitis with an inflammatory mass of pancreatic head: preoperative and postoperative functional assessment Hepatogastroenterology 50 2213–7 Occurrence Handle14696501
A Whipple (1935) ArticleTitleTreatment of carcinoma of ampulla of Vater Ann Surg 102 763–9 Occurrence Handle17856666 Occurrence Handle10.1097/00000658-193510000-00023 Occurrence Handle1:STN:280:DC%2BD2srktFOgtA%3D%3D
LW Traverso WP Longmire SuffixJr (1978) ArticleTitlePreservation of the pylorus in pancreaticoduodenectomy Surg Gynecol Obstet 146 959–62 Occurrence Handle653575 Occurrence Handle1:STN:280:CSeC1c7gt1E%3D
CF Frey GJ Smith (1987) ArticleTitleDescription and rationale of a new operation for chronic pancreatitis Pancreas 2 701–7 Occurrence Handle3438308 Occurrence Handle10.1097/00006676-198711000-00014 Occurrence Handle1:STN:280:BieC2cvkt1M%3D
RL Rossi J Rosthchild JW Braasch JL Munson SG ReMine (1987) ArticleTitlePancreatoduodenectomy in the management of chronic pancreatitis Arch Surg 122 416–20 Occurrence Handle3566523 Occurrence Handle1:STN:280:BiiC1cvgtVY%3D
C Bloechle JR Izbicki WT Knoefel T Kuechler CE Broelsch (1995) ArticleTitleAssessment of quality of life in chronic pancreatitis — results after duodenum-preserving resection of the pancreas Pancreas 11 77–85 Occurrence Handle7667246 Occurrence Handle10.1097/00006676-199507000-00008 Occurrence Handle1:STN:280:ByqA1MnnsVU%3D
DE Bockman M Buechler P Malfertheimer HG Beger (1988) ArticleTitleAnalysis of nerves in chronic pancreatitis Gastroenterology 94 1459–69 Occurrence Handle3360267 Occurrence Handle1:STN:280:BieC1Mnns10%3D
N Ebbehoj LB Svondsen P Madsen (1984) ArticleTitlePancreatic tissue pressure: techniques and pathophysiological aspects Scand J Gastroenterol 19 1066–8 Occurrence Handle6533777 Occurrence Handle1:STN:280:BiqC1M3jt10%3D
JR Izbicki C Bloechle DC Broeing WT Knoefel T Kuechler CE Broelsch (1998) ArticleTitleExtended drainage versus resection in surgery for chronic pancreatitis Ann Surg 228 771–9 Occurrence Handle9860476 Occurrence Handle10.1097/00000658-199812000-00008 Occurrence Handle1:STN:280:DyaK1M%2FnsFyiuw%3D%3D
M Schafer B Mullhaupt PA Clavien (2002) ArticleTitleEvidence-based pancreatic head resection for pancreatic cancer and chronic pancreatitis Ann Surg 236 137–48 Occurrence Handle12170018 Occurrence Handle10.1097/00000658-200208000-00001
JR Izbicki C Bloechle WT Knoefel T Kuechler KF Binmoeller CE Broelsch (1995) ArticleTitleDuodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial Ann Surg 221 350–8 Occurrence Handle7726670 Occurrence Handle10.1097/00000658-199504000-00004 Occurrence Handle1:STN:280:ByqB2cznsFM%3D
I Klempa M Spathny J Menzel I Baca R Nustede F Stockmann 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 after duodenum preserving resection of the head of the pancreas versus Whipple's operation Chirurg 66 350–9 Occurrence Handle7634946 Occurrence Handle1:STN:280:ByqA287msFQ%3D
GH Sakorafas AG Tsiotu (2002) ArticleTitleProximal pancreatectomy in the surgical management of chronic pancreatitis J Clin Gastroenterol 34 72–6 Occurrence Handle11743250 Occurrence Handle10.1097/00004836-200201000-00014
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chiang, KC., Yeh, CN., Hsu, JT. et al. Pancreaticoduodenectomy Versus Frey's Procedure for Chronic Pancreatitis: Preliminary Data on Outcome and Pancreatic Function. Surg Today 37, 961–966 (2007). https://doi.org/10.1007/s00595-007-3539-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-007-3539-z