Journal Article

Long-Term Outcome after 92 Duodenum-Preserving Pancreatic Head Resections for Chronic Pancreatitis: Comparison of Beger and Frey Procedures

Adam, Ulrich, Sick, Olivia, Makowiec, Frank, Riediger, Hartwig, Hopt, Ulrich Theodor, Keck, Tobias, Wellner, Ulrich Friedrich

2010

Overview

Introduction Duodenum-preserving pancreatic head resection may be an alternative to pancreatoduodenectomy or drainage procedures for chronic pancreatitis. There are few studies directly comparing the long-term outcome after the operations described by Beger and Frey. Methods One hundred thirteen patients underwent duodenum-preserving pancreatic head resection for complications of chronic pancreatitis. Follow-up was obtained in 92 patients (42 Beger, 50 Frey, median follow-up almost 5 years). Results Overall/surgery-related perioperative morbidity was 30%/20% (Frey) and 40%/31% (Beger). In long-term follow-up (Frey vs Beger), 62% vs 50% were completely free of pain, but 6% vs 19% had pain at least once per week or daily, and 32% vs 31% experienced pain attacks at least once per year (n.s.). Diabetes mellitus occured in 60% vs 57% (de novo 34% vs 17%). Rates of exocrine insufficiency were 76% vs. 74% (de novo 34% vs. 33%). Median gain in body weight was 2.5 vs 1.5 kg (n.s.), respectively. Four patients had clinically relevant biliary complications during follow-up requiring reintervention. Conclusions Our (nonrandomized) comparison of the long-term outcome after Frey and Beger procedures for chronic pancreatitis reveals a tendency for better pain control with the Frey operation. The functional outcomes were almost identical.

• Publisher: Springer-Verlag,Springer Nature B.V
• Subject: Adult / Aged / Chi-Square Distribution / Cohort Studies / Diabetes Mellitus - epidemiology / Diabetes Mellitus - etiology / Duodenum - surgery / Female / Follow-Up Studies / Gastroenterology / Humans / Male / Medical research / Medicine / Medicine & Public Health / Middle Aged / Original Article / Pain Measurement / Pancreas / Pancreatectomy - adverse effects / Pancreatectomy - methods / Pancreatectomy - mortality / Pancreatic Function Tests / Pancreatitis, Chronic - mortality / Pancreatitis, Chronic - pathology / Pancreatitis, Chronic - surgery / Perioperative Care - methods / Postoperative Complications - mortality / Postoperative Complications - physiopathology / Reoperation / Retrospective Studies / Risk Assessment / Severity of Illness Index / Statistics, Nonparametric / Surgery / Survival Rate / Time Factors / Treatment Outcome