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慢性胰腺炎的弗雷氏手术:一项叙述性综述。

Frey procedure for chronic pancreatitis: A narrative review.

作者信息

Ray Sukanta, Basu Chaitali, Dhali Arkadeep, Dhali Gopal Krishna

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.

Department of Ophthalmology, Central Hospital, South Eastern Railway, 11 Garden Reach Road, Kolkata, 700043, West Bengal, India.

出版信息

Ann Med Surg (Lond). 2022 Aug 4;80:104229. doi: 10.1016/j.amsu.2022.104229. eCollection 2022 Aug.

Abstract

Chronic pancreatitis is (CP) is a progressive inflammatory disease of the pancreas associated with disabling abdominal pain and gradual deterioration of exocrine and endocrine function. Up to 50% of patients with CP may require surgery during the course of the disease. The main indication for surgery is intractable abdominal pain not amenable to medical and endoscopic therapy. The type of surgery depends on pancreatic ductal diameter and associated parenchymal pathology like inflammatory head mass. Frey procedure (FP) is an effective method for control of pain in patients with enlarged pancreatic head. FP can be performed with a very low mortality and an acceptable morbidity. Compared with pancreaticoduodenectomy (PD), FP has favourable outcomes in terms of operation time, blood loss, morbidity, post-operative hospital stay, intensive care unit stay, and quality of life. FP has shorter operation time and lower morbidity in comparison to Beger procedure. But, long-term pain control and exocrine and endocrine dysfunctions are comparable between PD, Beger and FP. FP is technically easier than PD and Beger procedure. FP is thus a widely acceptable procedure for CP with enlarged pancreatic head in absence of a neoplasia.

摘要

慢性胰腺炎(CP)是一种胰腺的进行性炎症性疾病,伴有使人衰弱的腹痛以及外分泌和内分泌功能的逐渐恶化。高达50%的CP患者在疾病过程中可能需要手术。手术的主要指征是药物和内镜治疗均无法缓解的顽固性腹痛。手术类型取决于胰管直径以及相关的实质病变,如炎性头部肿块。Frey手术(FP)是控制胰头肿大患者疼痛的有效方法。FP的死亡率极低,发病率也可接受。与胰十二指肠切除术(PD)相比,FP在手术时间、失血量、发病率、术后住院时间、重症监护病房停留时间和生活质量方面都有较好的结果。与Beger手术相比,FP的手术时间更短,发病率更低。但是,PD、Beger手术和FP在长期疼痛控制以及外分泌和内分泌功能障碍方面相当。FP在技术上比PD和Beger手术更容易。因此,对于没有肿瘤形成的胰头肿大的CP患者,FP是一种广泛可接受的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b44/9422204/e53ed6350a9c/gr1.jpg

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