FREY’S PROCEDURE- TO ANALYSE THE OUTCOME OF THIS PROCEDURE IN CHRONIC PANCREATITIS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 29
Abstract
BACKGROUND Chronic Pancreatitis (CP) is a progressive inflammatory disease characterised by debilitating pain and pancreatic insufficiency. There is enormous personal and socio-economic impact on impairment of quality of life, inability to work and even shortening of life expectancy. Although, pancreaticoduodenectomy had been considered the standard surgical procedure for patients with CP because of its high post-op complications with exocrine and endocrine insufficiency, it is not preferred. This has led to a hybrid procedure described by Frey’s, which is used in our study for CP. We aim to analyse the short-term and long-term outcomes of Frey’s procedure at a tertiary care center in patients with chronic pancreatitis. MATERIALS AND METHODS A retrospective review of all CP patients who underwent Frey procedure were reviewed from January 2007-January 2016. Perioperative variables, short-term (30 days) and long-term (3 years) outcomes were reviewed. Data are frequency (%) or mean. RESULTS A total of 97 patients underwent Frey’s procedure. A total of 72 (70.7%) were men and 25 (29.3%) were women. Mean age was 38 years (range 14-66 years). Indications for surgery included intractable pain (n=97, 100%) and obstructive jaundice (n=4, 4.3%). 9 patients (32.6%) were diabetic preoperatively. Concomitant procedures include biliary drainage procedure was done for 4 patients (4.3%), i.e. choledochojejunostomy and splenectomy for 2 patients (2.1%), cholecystectomy (n=6, 6%). Short-term outcomes include surgical site infection (n=10, 10%), pancreatic leak (n=6, 5.82%) and 2 patients required reoperation for bleeding and no mortality (30 days), diabetic ketoacidosis (n=2, 2%). Pancreatic carcinoma was detected in 3 (2.1%) patients. Long-term outcomes include pain free status (n=80, 86.9%), median follow-up of 3 years. Redo pancreatic procedure was performed in 1 (4.3%) for anastomotic leak. CONCLUSION Frey’s procedure is a safe and effective pain palliative option for CP patients with intractable pain. Because of its relatively low complication rate, it should be considered first choice of procedure for chronic pancreatitis patients.
Authors and Affiliations
Shilpa Mariappa Casaba, Venugopal H. G, Nagesh N. S, Savitha Karlwad, Sathish O, Vinay B. N, Prasanna B
Keywords
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- EP ID EP217832
- DOI 10.18410/jebmh/2017/331
- Views 90
- Downloads 0
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