Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013
Extent of pancreatic fibrosis as a determinant of symptom resolution after the Frey procedure: a clinico-pathologic analysis.
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Cooper Michol A, Makary Martin A, Ng Julie, Cui Yunfeng, Singh Vikesh K, Matsukuma Karen, Andersen Dana K
Аннотация
OBJECTIVE: The aim of this study was to evaluate the association of histopathologic features of chronic pancreatitis and pain relief after the Frey procedure.
DESIGN: We retrospectively analyzed 35 patients who underwent the Frey procedure for chronic pancreatitis over a 5-year period (November 2005 to February 2011).
SETTING: Thirty-five patients with varied etiologies of chronic pancreatitis and persistent symptoms were referred to a multi-disciplinary pancreatitis clinic where a consensus decision to recommend surgery was established. The Frey procedure was then performed.
MAIN OUTCOME MEASURES: We compared symptomatic outcomes with the degree of pancreatic fibrosis, duct dilatation, and presence of pancreatic duct stones based on a blinded evaluation of resected pancreatic tissue.
RESULTS: Symptom resolution was associated with severe or extensive (>75 %) fibrosis and absence of symptom resolution was associated with mild or minimal (<25 %) fibrosis (chi-squared, p value < 0.05). Symptom resolution was associated with pancreatic duct >4 mm and absence of symptom resolution was associated with pancreatic duct ≤4 mm (chi-squared, p value < 0.05). There was no difference in outcomes for patients with and without pancreatic duct stones.
CONCLUSION: Symptom resolution after the Frey procedure is more likely in the setting of severe or extensive fibrosis due to chronic pancreatitis.
DESIGN: We retrospectively analyzed 35 patients who underwent the Frey procedure for chronic pancreatitis over a 5-year period (November 2005 to February 2011).
SETTING: Thirty-five patients with varied etiologies of chronic pancreatitis and persistent symptoms were referred to a multi-disciplinary pancreatitis clinic where a consensus decision to recommend surgery was established. The Frey procedure was then performed.
MAIN OUTCOME MEASURES: We compared symptomatic outcomes with the degree of pancreatic fibrosis, duct dilatation, and presence of pancreatic duct stones based on a blinded evaluation of resected pancreatic tissue.
RESULTS: Symptom resolution was associated with severe or extensive (>75 %) fibrosis and absence of symptom resolution was associated with mild or minimal (<25 %) fibrosis (chi-squared, p value < 0.05). Symptom resolution was associated with pancreatic duct >4 mm and absence of symptom resolution was associated with pancreatic duct ≤4 mm (chi-squared, p value < 0.05). There was no difference in outcomes for patients with and without pancreatic duct stones.
CONCLUSION: Symptom resolution after the Frey procedure is more likely in the setting of severe or extensive fibrosis due to chronic pancreatitis.