成人慢性胰腺炎Frey手术的短期和长期疗效
Short- and long-term outcome of Frey procedure for chronic pancreatitis in adults.
作者信息
Ray Sukanta, Das Kshaunish, Khamrui Sujan, Jana Koustav, Das Roby, Kumar Dilip, Ansari Zuber
机构信息
Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020, West Bengal, India.
Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020, West Bengal, India.
出版信息
Am J Surg. 2021 Oct;222(4):793-801. doi: 10.1016/j.amjsurg.2021.02.006. Epub 2021 Feb 11.
OBJECTIVE
To report our experience with Frey procedure (FP) for chronic pancreatitis (CP) in adults.
METHODS
Adult patients with CP, who underwent a FP between August 2007 and July 2018, were retrospectively reviewed.
RESULTS
Of the total 138 patients, 95 (69%) were male. The median age at operation was 36.5 years. The median pain-surgery interval was 48 months. Alcohol abuse was identified in 64 (46%) patients. The major indication for surgery was disabling pain (94%). There was no postoperative mortality. Postoperative complications developed in 43 (31%) patients. Median postoperative hospital stay was 9 days. Over a median follow-up of 65 months, 84% of patients had complete pain relief. Continuous pain and high preoperative Izbicki pain score were associated with incomplete pain control. New-onset diabetes and exocrine insufficiency developed in 31% and 27% of patients respectively. Longer duration of disease and previous pancreatic surgery were associated with the development of new-onset diabetes after the FP.
CONCLUSIONS
Frey procedure is safe with an acceptable perioperative complications and good long-term pain control.
目的
报告我们对成人慢性胰腺炎（CP）采用 Frey 手术（FP）的经验。
方法
对 2007 年 8 月至 2018 年 7 月期间接受 FP 手术的成年 CP 患者进行回顾性分析。
结果
138 例患者中，95 例（69%）为男性。手术时的中位年龄为 36.5 岁。疼痛至手术的中位间隔时间为 48 个月。64 例（46%）患者存在酒精滥用。手术的主要指征是顽固性疼痛（94%）。无术后死亡病例。43 例（31%）患者出现术后并发症。术后中位住院时间为 9 天。中位随访 65 个月时，84%的患者疼痛完全缓解。持续性疼痛和术前 Izbicki 疼痛评分高与疼痛控制不完全相关。分别有 31%和 27%的患者出现新发糖尿病和外分泌功能不全。病程较长和既往有胰腺手术史与 FP 术后新发糖尿病的发生有关。
结论
Frey 手术安全，围手术期并发症可接受，长期疼痛控制良好。
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