Assessment of Frey procedures: Japanese experience
Assessment of Frey procedures: Japanese experience
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DOI：
10.1007/s00534-009-0185-4
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发表时间：
2010-11-01
影响因子：
3
通讯作者：
Unno, Michiaki
中科院分区：
文献类型：
--
作者：
Egawa, Shinichi;Motoi, Fuyuhiko;Unno, Michiaki
Frey手术是一种安全、简便、可靠的方法，可以解决大多数慢性胰腺炎相关的问题。在长期随访中，胰尾出现意想不到的复发。从1992年到2008年，71名慢性胰腺炎患者在东北大学医院接受了Frey手术，研究了失败的模式和治疗或预防复发的新程序的原理。酒精性胰腺炎占92.6%，其次为特发性和遗传性慢性胰腺炎。一期手术除行Frey手术外，3例行胰尾联合切除，1例行胆总管十二指肠吻合术。随访率92.9%，中位时间46个月，术后早期并发症发生率18.4%，其中1例因脾动脉胃肠道出血再次手术。所有患者的疼痛均得到控制，无手术死亡。在采用Frey手术的62名患者的长期随访中，有8名患者炎症复发，需要再次手术。8例患者中有5例胰尾假性囊肿，行远端胰腺切除术(DP)，复发见于酗酒中年男性、遗传性和特发性胰腺炎患者。FREY-DP和FREY-SING-DP(SPDP)是治疗胰尾复发和预防胰尾复发安全有效的方法。
The Frey procedure, the coring out of the pancreatic head and longitudinal pancreaticojejunostomy, is a safe, easy, and reliable method to solve most of the problems associated with chronic pancreatitis. During long-term follow up, unexpected relapse in the pancreatic tail was encountered. The pattern of failure and the rationale for a new procedure to treat or prevent such relapse were investigated.From 1992 to 2008, 71 patients with chronic pancreatitis underwent the Frey procedure at Tohoku University Hospital. The etiology was alcoholic in 92.6% of them, followed in incidence by idiopathic and hereditary chronic pancreatitis. In the primary operation, besides the Frey procedure, combined resection of the pancreatic tail was performed in three patients, and choledochoduodenostomy was performed in one patient. The follow-up rate was 92.9%, with a median period of 46 months.The incidence of early postoperative complications was 18.4%, with one reoperation for gastrointestinal bleeding from the splenic artery. Pain control was achieved in all patients and there was no operative mortality. During the long-term follow up of 62 patients with the Frey procedure, eight patients had relapse of inflammation and required reoperation. Five of these eight patients had a pseudocyst in the pancreatic tail and underwent distal pancreatectomy (DP).Relapse occurred in alcoholic middle-aged male patients, and in the patients with hereditary and idiopathic pancreatitis. Frey-DP and Frey-spleen-preserving DP (SPDP) procedures can be performed safely and effectively to treat the relapse and to prevent relapse in the pancreatic tail.