Quality of Life after Frey Procedure in Treatment of Chronic Pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIShao-jun , TANChun-lu , ZHANGZhao-da ,  TIANBo-le

Department of Hepato-Billiary-Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province,;

Corresponding?author：

TIANBo-le, Email: bo-le@medmail.com.cn

Keywords：

Chronic pancreatitis; Frey procedure; Pain; Quality of life

DOI：

10.7507/1007-9424.20160191

Video：

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Objective To explore the effect of Frey procedure on patients with chronic pancreatitis, and evaluate pain control as well as the quality of life (QOL) after Frey procedure. Methods The clinical data of 81 patients with chronic pancreatitis who underwent Frey procedure in West China Hospital of Sichuan University from January 2010 to January 2015 were retrospectively analyzed. Izbicki pain score and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) were used to assess pain and QOL respectively. Results The mean value of operative time were (252±70) minutes (180-430 minutes), the mean value of blood loss were (220±142) mL (100-550 mL), and the mean value of hospital stay were (14.1±4.9) days (8-36 days). After Frey procedure, delayed gastric emptying occurred in 4 patients, hemorrhage occurred in 1 patient, wound infection or fat liquefaction occurred in 6 patients, abdominal infection and pyoperitoneum occurred in 4 patients, and pancreatic fistula occurred in 3 patients. All of the patients were followed up for 4-60 months, and the median time were 28 months. During the follow up period, 11 patients developed diabetes and 10 patients developed steatorrhea, respectively. In addition, the pain related score, including frequency of pain attacks, visual analogue scale of pain, analgetic medication, inability to work, and total pain score, were significantly reduced after Frey procedure (P＜0.001). Moreover, all the functional scales of EORTC -QLQ-C30, except for cognitive function, were improved postoperatively (P ＜0.001). Regarding to the symptom scales, the score of fatigue, pain, loss of appetite, and loss of body weight were significantly lower after surgery (P＜0.050). The scores of QOL after surgery were higher than before surgery (P＜0.001). Conclusion Frey procedure results in good post-operative pain control and significant improvement in qol.

Citation： LIShao-jun, TANChun-lu, ZHANGZhao-da, TIANBo-le. Quality of Life after Frey Procedure in Treatment of Chronic Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 722-726. doi: 10.7507/1007-9424.20160191 Copy

1.	Forsmark CE. Management of chronic pancreatitis. Gastroenterology, 2013, 144(6): 1282-1291.
2.	R?sch T, Daniel S, Scholz M, et al. Endoscopic treatment of chronic pancreatitis: a multicenter study of 1 000 patients with long-term follow-up. Endoscopy, 2002, 34(10): 765-771.
3.	Gabbrielli A, Pandolfi M, Mutignani M, et al. Efficacy of main pancreatic-duct endoscopic drainage in patients with chronic pancreatitis, continuous pain, and dilated duct. Gastrointest Endosc, 2005, 61(4): 576-581.
4.	Binmoeller KF, Jue P, Seifert H, et al. Endoscopic pancreatic stent drainage in chronic pancreatitis and a dominant stricture: long-term results. Endoscopy, 1995, 27(9): 638-644.
5.	Roch A, Teyssedou J, Mutter D, et al. Chronic pancreatitis: a surgical disease? Role of the Frey procedure. World J Gastrointest Surg, 2014, 6(7): 129-135.
6.	Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis. Ann Surg, 2010, 251(1): 18-32.
7.	Keck T, Wellner UF, Riediger H, et al. Long-term outcome after 92 duodenum-preserving pancreatic head resections for chronic pancreatitis: comparison of Beger and Frey procedures. J Gastrointest Surg, 2010, 14(3): 549-556.
8.	Chiang KC, Yeh CN, Hsu JT, et al. Pancreaticoduodenectomy versus Frey鈥檚 procedure for chronic pancreatitis: preliminary data on outcome and pancreatic function. Surg Today, 2007, 37(11): 961-966.
9.	Bachmann K, Tomkoetter L, Erbes J, et al. Beger and Frey procedures for treatment of chronic pancreatitis: comparison of outcomes at 16-year follow-up. J Am Coll Surg, 2014, 219(2): 208-216.
10.	Sudo T, Murakami Y, Uemura K, et al. Short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis: a retrospective Japanese single-center study. J Hepatobiliary Pancreat Sci, 2014, 21(6): 426-432.
11.	涓　崕鍖誨　浼氬　縐戝　鍒嗕細鑳拌吅澶栫　瀛︾粍. 鎱㈡€ц儼鑵虹値璇婃不鎸囧崡 (2014). 涓　浗瀹炵敤澶栫　鏉傚織, 2015, 35(3): 277-282.
12.	Pothula Rajendra VK, Sivanpillay Mahadevan S, Parvathareddy SR, et al. Frey鈥檚 pancreaticojejunostomy in tropical pancreatitis: assessment of quality of life. A prospective study. World J Surg, 2014, 38(12): 3235-3247.
13.	Bloechle C, Izbicki JR, Knoefel WT, et al. Quality of life in chronic pancreatitis鈥攔esults after duodenum-preserving resection of the head of the pancreas. Pancreas, 1995, 11(1): 77-85.
14.	Aaronson NK, Ahmedzai S, Bergman B, et al. The EuropeanOrganization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 1993, 85(5): 365-376.
15.	Pezzilli R, Morselli Labate AM, Ceciliato R, et al. Quality of life in patients with chronic pancreatitis. Dig Liver Dis, 2005, 37(3): 181-189.
16.	Chauhan S, Forsmark CE. Pain management in chronic pancreatitis: a treatment algorithm. Best Pract Res Clin Gastroenterol, 2010, 24(3): 323-335.
17.	Lieb JG 2nd, Forsmark CE. Review article: pain and chronic pancreatitis. Aliment Pharmacol Ther, 2009, 29(7): 706-719.
18.	Pasricha PJ. Unraveling the mystery of pain in chronic pancreatitis. Nat Rev Gastroenterol Hepatol, 2012, 9(3): 140-151.
19.	Izbicki JR, Bloechle C, Knoefel WT, et al. Drainage versus resection in surgical therapy of chronic pancreatitis of the head of the pancreas: a randomized study. Chirurg, 1997, 68(4): 369-377.
20.	Mullady DK, Yadav D, Amann ST, et al. Type of pain, painassociated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study. Gut, 2011, 60(1): 77-84.
21.	Pezzilli R, Morselli Labate AM, Fantini L, et al. Quality of life and clinical indicators for chronic pancreatitis patients in a 2-year follow-up study. Pancreas, 2007, 34(2): 191-196.
22.	Pujahari AK. Chronic pancreatitis: a review. Indian J Surg, 2015, 77(Suppl 3): 1348-1358.
23.	van Loo ES, van Baal MC, Gooszen HG, et al. Long-term quality of life after surgery for chronic pancreatitis. Br J Surg, 2010, 97(7): 1079-1086.
24.	Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology, 2000, 119(5): 1324-1332.
25.	Negi S, Singh A, Chaudhary A. Pain relief after Frey,s procedure for chronic pancreatitis. Br J Surg, 2010, 97(7): 1087-1095.

1. Forsmark CE. Management of chronic pancreatitis. Gastroenterology, 2013, 144(6): 1282-1291.
2. R?sch T, Daniel S, Scholz M, et al. Endoscopic treatment of chronic pancreatitis: a multicenter study of 1 000 patients with long-term follow-up. Endoscopy, 2002, 34(10): 765-771.
3. Gabbrielli A, Pandolfi M, Mutignani M, et al. Efficacy of main pancreatic-duct endoscopic drainage in patients with chronic pancreatitis, continuous pain, and dilated duct. Gastrointest Endosc, 2005, 61(4): 576-581.
4. Binmoeller KF, Jue P, Seifert H, et al. Endoscopic pancreatic stent drainage in chronic pancreatitis and a dominant stricture: long-term results. Endoscopy, 1995, 27(9): 638-644.
5. Roch A, Teyssedou J, Mutter D, et al. Chronic pancreatitis: a surgical disease? Role of the Frey procedure. World J Gastrointest Surg, 2014, 6(7): 129-135.
6. Andersen DK, Frey CF. The evolution of the surgical treatment of chronic pancreatitis. Ann Surg, 2010, 251(1): 18-32.
7. Keck T, Wellner UF, Riediger H, et al. Long-term outcome after 92 duodenum-preserving pancreatic head resections for chronic pancreatitis: comparison of Beger and Frey procedures. J Gastrointest Surg, 2010, 14(3): 549-556.
8. Chiang KC, Yeh CN, Hsu JT, et al. Pancreaticoduodenectomy versus Frey鈥檚 procedure for chronic pancreatitis: preliminary data on outcome and pancreatic function. Surg Today, 2007, 37(11): 961-966.
9. Bachmann K, Tomkoetter L, Erbes J, et al. Beger and Frey procedures for treatment of chronic pancreatitis: comparison of outcomes at 16-year follow-up. J Am Coll Surg, 2014, 219(2): 208-216.
10. Sudo T, Murakami Y, Uemura K, et al. Short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis: a retrospective Japanese single-center study. J Hepatobiliary Pancreat Sci, 2014, 21(6): 426-432.
11. 涓　崕鍖誨　浼氬　縐戝　鍒嗕細鑳拌吅澶栫　瀛︾粍. 鎱㈡€ц儼鑵虹値璇婃不鎸囧崡 (2014). 涓　浗瀹炵敤澶栫　鏉傚織, 2015, 35(3): 277-282.
12. Pothula Rajendra VK, Sivanpillay Mahadevan S, Parvathareddy SR, et al. Frey鈥檚 pancreaticojejunostomy in tropical pancreatitis: assessment of quality of life. A prospective study. World J Surg, 2014, 38(12): 3235-3247.
13. Bloechle C, Izbicki JR, Knoefel WT, et al. Quality of life in chronic pancreatitis鈥攔esults after duodenum-preserving resection of the head of the pancreas. Pancreas, 1995, 11(1): 77-85.
14. Aaronson NK, Ahmedzai S, Bergman B, et al. The EuropeanOrganization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 1993, 85(5): 365-376.
15. Pezzilli R, Morselli Labate AM, Ceciliato R, et al. Quality of life in patients with chronic pancreatitis. Dig Liver Dis, 2005, 37(3): 181-189.
16. Chauhan S, Forsmark CE. Pain management in chronic pancreatitis: a treatment algorithm. Best Pract Res Clin Gastroenterol, 2010, 24(3): 323-335.
17. Lieb JG 2nd, Forsmark CE. Review article: pain and chronic pancreatitis. Aliment Pharmacol Ther, 2009, 29(7): 706-719.
18. Pasricha PJ. Unraveling the mystery of pain in chronic pancreatitis. Nat Rev Gastroenterol Hepatol, 2012, 9(3): 140-151.
19. Izbicki JR, Bloechle C, Knoefel WT, et al. Drainage versus resection in surgical therapy of chronic pancreatitis of the head of the pancreas: a randomized study. Chirurg, 1997, 68(4): 369-377.
20. Mullady DK, Yadav D, Amann ST, et al. Type of pain, painassociated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study. Gut, 2011, 60(1): 77-84.
21. Pezzilli R, Morselli Labate AM, Fantini L, et al. Quality of life and clinical indicators for chronic pancreatitis patients in a 2-year follow-up study. Pancreas, 2007, 34(2): 191-196.
22. Pujahari AK. Chronic pancreatitis: a review. Indian J Surg, 2015, 77(Suppl 3): 1348-1358.
23. van Loo ES, van Baal MC, Gooszen HG, et al. Long-term quality of life after surgery for chronic pancreatitis. Br J Surg, 2010, 97(7): 1079-1086.
24. Malka D, Hammel P, Sauvanet A, et al. Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology, 2000, 119(5): 1324-1332.
25. Negi S, Singh A, Chaudhary A. Pain relief after Frey,s procedure for chronic pancreatitis. Br J Surg, 2010, 97(7): 1087-1095.

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Quality of Life after Frey Procedure in Treatment of Chronic Pancreatitis

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