Tan Chun-Lu, Zhang Hao, Yang Min, Li Shao-Jun, Liu Xu-Bao, Li Ke-Zhou
Chun-Lu Tan, Hao Zhang, Min Yang, Shao-Jun Li, Xu-Bao Liu, Ke-Zhou Li, Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2016 Dec 21;22(47):10415-10423. doi: 10.3748/wjg.v22.i47.10415.
To retrospectively review patients with chronic pancreatitis (CP) treated with Frey's procedures between January 2009 and January 2014.
A retrospective review was performed of patients with CP treated with Frey's procedures between January 2009 and January 2014 in the Department of Pancreatic Surgery. A cross-sectional study of postoperative pain relief, quality of life (QoL), and alcohol and nicotine abuse was performed by clinical interview, letters and telephone interview in January 2016. QoL of patients was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) version 3.0. The patients were requested to fill in the questionnaires by themselves correspondence or clinical interview.
A total of 80 patients were enrolled for analysis, including 44 who underwent the original Frey's procedure and 36 who underwent a modified Frey's procedure. The mean age was 46 years in the original group and 48 years in the modified group. Thirty-five male patients (80%) were in the original group and 33 (92%) in the modified group. There were no differences in the operating time, blood loss, and postoperative morbidity and mortality between the two groups. The mean follow-up was 50.3 mo in the original group and 48.7 mo in the modified group. There were no differences in endocrine and exocrine function preservation between the two groups. The original Frey's procedure resulted in significantly better pain relief, as shown by 5-year follow-up ( = 0.032), better emotional status ( = 0.047) and fewer fatigue symptoms ( = 0.028). When stratifying these patients by the M-ANNHEIM severity index, no impact was found on pain relief after the two types of surgery.
The original Frey's procedure is as safe as the modified procedure, but the former yields better pain relief. The severity of CP does not affect postoperative pain relief.
回顾性分析2009年1月至2014年1月间接受弗雷氏手术治疗的慢性胰腺炎（CP）患者。
对2009年1月至2014年1月在胰腺外科接受弗雷氏手术治疗的CP患者进行回顾性分析。2016年1月通过临床访谈、信件及电话访谈对术后疼痛缓解情况、生活质量（QoL）以及酒精和尼古丁滥用情况进行横断面研究。采用欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）3.0版评估患者的生活质量。要求患者通过信件或临床访谈自行填写问卷。
共纳入80例患者进行分析，其中44例行原始弗雷氏手术，36例行改良弗雷氏手术。原始组平均年龄46岁，改良组平均年龄48岁。原始组有35例男性患者（80%），改良组有33例（92%）。两组在手术时间、出血量、术后发病率和死亡率方面无差异。原始组平均随访50.3个月，改良组平均随访48.7个月。两组在内分泌和外分泌功能保留方面无差异。5年随访结果显示，原始弗雷氏手术在疼痛缓解方面效果显著更好（P = 0.032），情绪状态更好（P = 0.047），疲劳症状更少（P = 0.028）。根据M-ANNHEIM严重程度指数对这些患者进行分层时，发现两种手术对疼痛缓解均无影响。
原始弗雷氏手术与改良手术一样安全，但前者在疼痛缓解方面效果更好。CP的严重程度不影响术后疼痛缓解。
