Surgical outcomes of the Frey procedure for chronic pancreatitis: correlation between preoperative characteristics and the histological severity of pancreatic fibrosis
Surgical outcomes of the Frey procedure for chronic pancreatitis: correlation between preoperative characteristics and the histological severity of pancreatic fibrosis
复制标题
慢性胰腺炎弗雷手术的手术结果：术前特征与胰腺纤维化组织学严重程度之间的相关性
DOI：
10.1007/s00595-023-02653-5
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发表时间：
2023
期刊：
影响因子：
2.5
通讯作者：
Mizuno Shugo
中科院分区：
文献类型：
--
作者：
Tanemura Akihiro;Hayashi Akinobu;Maeda Koki;Shinkai Toru;Ito Takahiro;Hayasaki Aoi;Gyoten Kazuyuki;Fujii Takehiro;Iizawa Yusuke;Murata Yasuhiro;Kuriyama Naohisa;Kishiwada Masashi;Mizuno Shugo
目的评价Frey手术治疗慢性胰腺炎(CP)的疗效，明确其术前特点与组织学严重程度的关系。对取自胰头的标本进行CP严重程度评估。结果26例患者均获得长期疼痛缓解，其中19例(63%)疼痛完全缓解。术后1年白蛋白水平较术前显著升高(p= 0.038)。26例患者的组织学纤维化评估结果如下：正常(n= 4；15%)、轻度(n= 8；31%)、中度(n= 2；8%)和重度(n= 12；46%)。根据纤维化程度分为正常/轻度组(n= 12例)和中度/重度组(n= 14例)。术前CT显示弥漫性钙化发生率(71%vs.17%，p= 0.008)和胰岛素免疫组织化学显示胰岛萎缩发生率(100%vs.33%，p<； 0.001)均显著高于正常组和轻度组。根据术前影像检查中钙化的程度，可以预测纤维化的严重程度。
PurposeTo evaluate the efficacy of the Frey procedure and clarify the relationship between preoperative characteristics and the histological severity of chronic pancreatitis (CP).MethodsThirty patients who underwent the Frey procedure for CP between January, 2002 and December, 2020, at our hospital, were enrolled in this study. The specimen cored out of the pancreatic head was assessed for CP severity. We evaluated preoperative status and surgical outcomes according to CP severity.ResultsLong-term pain relief was achieved in all 26 patients with sustained long-term follow-up, with complete pain relief attained in 19 (63%). Albumin levels were significantly higher 1 year postoperatively than preoperatively (p= 0.038). Histological fibrosis was assessed in the 26 patients as follows: normal (n= 4; 15%), mild (n= 8; 31%), moderate (n= 2; 8%), and severe (n= 12; 46%). These patients were divided into two groups according to the severity of fibrosis: normal/mild (n= 12) and moderate/severe (n= 14). The rates of diffuse calcification on preoperative computed tomography (CT) (71% vs. 17%,p= 0.008) and islet atrophy on insulin immunohistochemistry (100% vs. 33%,p< 0.001) were significantly higher in the moderate/severe group than in the normal/mild group.ConclusionThe Frey procedure can achieve good pain relief and improve nutritional status. The severity of fibrosis can be predicted based on the extent of calcification on preoperative imaging studies.