Pessaux Patrick, Kianmanesh Reza, Regimbeau Jean-Marc, Sastre Bernard, Delcenserie Richard, Sielezneff Igor, Arnaud Jean-Pierre, Sauvanet Alain
Department of Digestive Surgery, University Hospital, Angers, France.
Pancreas. 2006 Nov;33(4):354-8. doi: 10.1097/01.mpa.0000236736.77359.3a.
The aim of this multicenter study was to report the short-term results of the Frey procedure in the treatment of chronic pancreatitis.
For the period between September 2000 and January 2005, 34 Frey procedures were performed for chronic pancreatitis in 4 university hospitals. This study includes 31 men (91%) and 3 women (9%), with a mean age of 48 +/- 6 years (range, 32-58 years). The etiology of chronic pancreatitis was chronic alcohol ingestion in 32 patients (94%) and hereditary chronic pancreatitis in 2 patients. The indications of surgery were abdominal pain in all patients, requiring opiates in 59% (n = 20) and associated with a weight loss in 79% (n = 27).
There was no mortality. Eleven postoperative surgical complications occurred in 7 patients (20%). Three patients had a single complication, and 4 patients had 2 complications. Pancreatic fistula occurred in 4 patients and healed under conservative management in all cases. One patient had massive bleeding from the stump of gastroduodenal artery requiring reoperation. The mean hospital stay was 16 +/- 8 days (range, 9-40 days). The mean follow-up was 15 +/- 12 months (range, 3-37 months). At the time of the last follow-up visit, the examiner judged that 19 patients (56%) have complete pain relief and 11 patients (32%) have substantial pain relief. No patient used narcotic analgesics postoperatively. Seven patients developed diabetes mellitus, requiring insulin (n = 1), oral hypoglycemic agents (n = 5), and diet adjustment (n = 1). Four patients developed exocrine insufficiency. Weight increases with a mean of 4.8 +/- 5.4 kg (range, 1-24 kg) in 27 patients (79%).
Frey procedure appears as a safe technique with low mortality and morbidity rates and allows effective pain relief in about 90% of patients.
本多中心研究旨在报告弗雷氏手术治疗慢性胰腺炎的短期结果。
在2000年9月至2005年1月期间，4所大学医院对34例慢性胰腺炎患者实施了弗雷氏手术。本研究包括31名男性（91%）和3名女性（9%），平均年龄为48±6岁（范围32 - 58岁）。慢性胰腺炎的病因是32例患者（94%）长期饮酒，2例患者为遗传性慢性胰腺炎。所有患者的手术指征均为腹痛，其中59%（n = 20）的患者需要使用阿片类药物，79%（n = 27）的患者伴有体重减轻。
无死亡病例。7例患者（20%）发生了11例术后手术并发症。3例患者有单一并发症，4例患者有2种并发症。4例患者发生胰瘘，均经保守治疗治愈。1例患者胃十二指肠动脉残端大量出血，需再次手术。平均住院时间为16±8天（范围9 - 40天）。平均随访时间为15±12个月（范围3 - 37个月）。在最后一次随访时，检查者判断19例患者（56%）疼痛完全缓解，11例患者（32%）疼痛明显缓解。术后无患者使用麻醉性镇痛药。7例患者发生糖尿病，其中1例需要胰岛素治疗，5例需要口服降糖药，1例需要调整饮食。4例患者出现外分泌功能不全。27例患者（79%）体重增加，平均增加4.8±5.4 kg（范围1 - 24 kg）。
弗雷氏手术似乎是一种安全的技术，死亡率和发病率较低，约90%的患者疼痛能得到有效缓解。
