Ueda Junji, Miyasaka Yoshihiro, Ohtsuka Takao, Takahata Shunichi, Tanaka Masao
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
J Hepatobiliary Pancreat Sci. 2015 Mar;22(3):211-6. doi: 10.1002/jhbp.176. Epub 2014 Oct 22.
The aim of this study was to determine the short- and long-term results of the Frey procedure for chronic pancreatitis.
From November 1998 to December 2013, 41 patients underwent the Frey procedure for painful chronic pancreatitis at Kyushu University Hospital. The short- and long-term results of the Frey procedure including mortality, morbidity, pain relief, weight gain and pancreatic endocrine function were analyzed. The long-term results were analyzed in 29 patients who had been followed-up for more than 12 months. The long-term follow-up rate was 85%.
There was no mortality. Early postoperative complications occurred in seven patients (17%), including pancreatic fistula in four (10%, International Study Group of Pancreatic Fistula ISGPF grade B) and hemorrhage in three (7%). Long-term relief of abdominal pain was achieved in 90% (26/29) of cases. One patient developed relapse of inflammation of the head of pancreas during the follow-up period, necessitating pylorus-resecting pancreatoduodenectomy. Only two patients (7%) developed new-onset diabetes mellitus after the Frey procedure during the follow-up period.
The Frey procedure for painful chronic pancreatitis may be safe and pancreatic endocrine function is preserved. Complete decompression of the pancreatic ducts in the head of pancreas and full length drainage of the main pancreatic duct from the head of pancreas to the tail may be important in the Frey procedure to prevent recurrence of acute inflammation.
本研究旨在确定弗雷氏手术治疗慢性胰腺炎的短期和长期效果。
1998年11月至2013年12月，41例患者在九州大学医院接受了弗雷氏手术治疗疼痛性慢性胰腺炎。分析了弗雷氏手术的短期和长期效果，包括死亡率、发病率、疼痛缓解、体重增加和胰腺内分泌功能。对29例随访超过12个月的患者进行了长期效果分析。长期随访率为85%。
无死亡病例。7例患者（17%）出现早期术后并发症，包括4例胰瘘（10%，国际胰腺瘘研究组ISGPF B级）和3例出血（7%）。90%（26/29）的病例实现了腹痛的长期缓解。1例患者在随访期间出现胰头炎症复发，需要行幽门切除胰十二指肠切除术。随访期间，仅2例患者（7%）在弗雷氏手术后出现新发糖尿病。
弗雷氏手术治疗疼痛性慢性胰腺炎可能是安全的，且能保留胰腺内分泌功能。在弗雷氏手术中，胰腺头部胰管的完全减压以及主胰管从胰头到胰尾的全程引流对于预防急性炎症复发可能很重要。
