Frey’s plus versus Frey’s procedure for chronic pancreatitis: Analysis of postoperative outcomes and quality of life

Background: Pancreatic head coring procedure, an organ preserving surgery in which diseased head of pancreas is cored with drainage of main pancreatic duct by lateral pancreatico-jejunostomy. Chronic pancreatitis is a persistently occurring inflammatory disease that causes pancreatic duct stones or calcification, stricture, dilatation of pancreatic duct and irreversible morphological changes resulting intractable pain and losses of exocrine and endocrine function. Appropriate management protocol recognizing underlying pathology, can prevent complications and improves the quality of life. Apart from ductal decompression, in Frey’s’ procedure resection of the “pacemaker of pain” (Head of the pancreas) gives excellent outcome.Methods: In this prospective observational study, we have intended to further validate the Frey’s procedure an effective surgical method in head dominant severe chronic pancreatitis. The study was carried out on 106 Bangladeshi patients who underwent Frey’s Procedure with Lateral Pancreaticojejunostomy from January 2000 to December 2017.Result: The study revealed 51 patients (48.11%) were in 3rd decade of life with 45 male and 61 female. We found 77 patients presented with diabetes mellitus, mostly on insulin. Steatorrhoea was noted in 39 patients and Malnutrition in 79 patients. Visual Analog Scale (VAS) was used for scoring pain. Postoperative morbidity was noted in 29 patients 27.35 % cases, but there was no anastomotic leakage or mortality in the immediate postoperative period in our series.Conclusion: Quality of life has always been the most important decisive factor for patients with severe chronic Pancreatitis. Pain is the predominant clinical feature and very difficult to control. Correction of diabetes and malnutrition are major challenges too. This study revealed, Frey’s procedure with adequate ductal clearance with wide pancreato-jejunal anastomosis in head dominant severe chronic pancreatitis is key to better pain control, improves quality of life and prevents recurrence.Birdem Med J 2018; 8(2): 151-158

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Long-term quality of life after surgery for chronic pancreatitis (Br J Surg 2010; 97: 1079-1086) Pain relief after Frey's procedure for chronic pancreatitis (Br J Surg 2010; 97: 1087-1095)

British Journal of Surgery ◽

10.1002/bjs.7117 ◽

2010 ◽

Vol 97 (7) ◽

pp. 1095-1095

Author(s):

C. W. Imrie

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Pain Relief ◽

Frey’S Procedure

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Deterioration of quality of life in patients with chronic pancreatitis

Gastroenterology ◽

10.1016/s0016-5085(01)83218-2 ◽

2001 ◽

Vol 120 (5) ◽

pp. A647-A647

Author(s):

M WEHLER ◽

R NICHTERLEIN ◽

B FISCHER ◽

M FARNBACHER ◽

U REULBACH ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis

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Hospitalization, frequency of interventions and quality of life after endoscopic, surgical or conservative treatment in patients with chronic pancreatitis

Zeitschrift für Gastroenterologie ◽

10.1055/s-2008-1081536 ◽

2008 ◽

Vol 46 (06) ◽

Author(s):

K Rutter ◽

A Ferlitsch ◽

P Wimmer ◽

T Sautner ◽

A Püspök ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Conservative Treatment

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Clinical characteristics and quality of life among Sri Lankan patients with chronic pancreatitis

Journal of International Medical Research ◽

10.1177/0300060520979875 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052097987

Author(s):

Umesh Jayarajah ◽

Thisaru Widyarathne ◽

Metthananda Nawarathne ◽

Sivananthan Raguvaran ◽

Nishanthan Subramaniam ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Chronic Pancreatitis ◽

Clinical Characteristics ◽

Considerable Proportion ◽

Intractable Pain ◽

Life Questionnaire ◽

European Organization ◽

Loss Of Appetite

Objective We aimed to describe the clinical characteristics of chronic pancreatitis (CP) and patient quality of life (QOL) in a resource-limited setting. Methods We performed a cross-sectional study including patients with clinical and radiological features of CP. We collected clinical data and assessed QOL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire. Results We included 103 patients (median age 44 years, 84 men). Median age at symptom onset was 36 (4–78) years. Around 70% of patients had diabetes mellitus and 62.1% had consumed alcohol; 36 (35%) were current smokers. The mean overall global QOL score was 68.7. Most patients (91.3%) sought treatment from multiple centers. Nineteen (18.5%) had pancreatic stone disease, 38 (36.9%) had persistent abdominal pain (median severity 7.8/10, 59 (57.3%) had steatorrhea, and 56 (54.4%) had jaundice. Poor QOL was significantly associated with weight loss, loss of appetite, and intractable pain. No correlation with age, sex, or alcohol consumption was noted. Conclusion A considerable proportion of patients with CP had troublesome symptoms. Intractable pain, loss of appetite, and weight loss were significantly associated with poor QOL. Further assessment is needed of patients’ psychosocial well-being and its association with QOL.

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Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

Fizioterapevt (Physiotherapist) ◽

10.33920/med-14-2012-01 ◽

2020 ◽

pp. 8-14

Author(s):

R. M. Mallaeva ◽

A. N. Makhinko ◽

M. B. Uzdenov

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Drug Therapy ◽

Clinical Manifestations ◽

Medical Rehabilitation ◽

Control Group ◽

Physical Factors ◽

Standard Drug ◽

Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

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