Izbicki J R, Bloechle C
Abteilung für Allgemeinchirurgie, Universitäts-Krankenhauses Eppendorf, Universität Hamburg.
Chirurg. 1997 Sep;68(9):865-73. doi: 10.1007/s001040050286.
Intraductal and intraparenchymal hypertension represent the rationale for surgical drainage procedures in the treatment of chronic pancreatitis. "Simple" drainage procedures such as longitudinal pancreaticojejunostomy according to Partington-Rochelle have to be distinguished from "extended" drainage operations, e.g. the combination of longitudinal pancreaticojejunostomy with limited local excision of the pancreatic head. This "extended" drainage procedure according to Frey is just as effective as resective procedures in terms of persistent pain relief and definitive management of pancreatitis-associated complications of adjacent organs, i.e. distal common bile duct and duodenal stenosis. This operation also addresses an inflammatory mass in the pancreatic head. In contrast to "simple" drainage procedures the Frey operation allows reliable exclusion of pancreatic carcinoma. With low perioperative morbidity and zero mortality the Frey procedure significantly improves quality of life and leads to social and occupational rehabilitation.
导管内和实质内高压是慢性胰腺炎外科引流手术的理论依据。必须将“简单”的引流手术，如根据帕廷顿-罗谢尔法进行的纵行胰空肠吻合术，与“扩大”的引流手术区分开来，例如纵行胰空肠吻合术与胰头局部有限切除相结合。这种根据弗雷法进行的“扩大”引流手术，在持续缓解疼痛以及明确处理胰腺炎相关的邻近器官并发症（即胆总管远端和十二指肠狭窄）方面，与切除手术同样有效。该手术还能处理胰头的炎性肿块。与“简单”引流手术不同，弗雷手术能够可靠地排除胰腺癌。弗雷手术围手术期发病率低且死亡率为零，显著提高了生活质量，并实现了社会和职业康复。
