S Negi1, A Singh, A Chaudhary. 1. Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India.
Abstract
BACKGROUND: Few studies have addressed long-term pain relief after Frey's procedure (local head resection with lateral pancreaticojejunostomy, LR-LPJ) for chronic pancreatitis. This retrospective study evaluated pain control using a validated score and risk factors associated with failure to achieve complete pain relief following LR-LPJ. METHODS: Sixty of 134 patients with chronic pancreatitis underwent LR-LPJ and were evaluated prospectively using the Izbicki pain score before surgery, and 1, 2, 5 and 7 years later. Analysis was on an intention-to-treat basis and predictors of complete pain relief were identified by multivariable analysis. RESULTS: After a median follow-up of 6.4 years, the median pain score was reduced from 46.4 to 10.0 (P < 0.001) with partial or complete pain relief in 75 per cent of patients, and a significant reduction in median number of episodes requiring hospitalization (from 4 to 0; P < 0.001). Preoperative use of opiate medication (odds ratio (OR) 30.14; P = 0.015), continuous pattern of pain (OR 22.65; P = 0.025) and occurrence of postoperative complications (OR 10.52; P = 0.030) were significant predictors of failure to achieve complete pain relief after surgery. CONCLUSION: Frey's procedure leads to significant and sustained long-term pain relief in patients with chronic pancreatitis. Patients should be referred for surgery before opiates are needed to relieve pain. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
BACKGROUND: Few studies have addressed long-term pain relief after Frey's procedure (local head resection with lateral pancreaticojejunostomy, LR-LPJ) for chronic pancreatitis. This retrospective study evaluated pain control using a validated score and risk factors associated with failure to achieve complete pain relief following LR-LPJ. METHODS: Sixty of 134 patients with chronic pancreatitis underwent LR-LPJ and were evaluated prospectively using the Izbicki pain score before surgery, and 1, 2, 5 and 7 years later. Analysis was on an intention-to-treat basis and predictors of complete pain relief were identified by multivariable analysis. RESULTS: After a median follow-up of 6.4 years, the median pain score was reduced from 46.4 to 10.0 (P < 0.001) with partial or complete pain relief in 75 per cent of patients, and a significant reduction in median number of episodes requiring hospitalization (from 4 to 0; P < 0.001). Preoperative use of opiate medication (odds ratio (OR) 30.14; P = 0.015), continuous pattern of pain (OR 22.65; P = 0.025) and occurrence of postoperative complications (OR 10.52; P = 0.030) were significant predictors of failure to achieve complete pain relief after surgery. CONCLUSION: Frey's procedure leads to significant and sustained long-term pain relief in patients with chronic pancreatitis. Patients should be referred for surgery before opiates are needed to relieve pain. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors: Yama Issa; Usama Ahmed Ali; Stefan A W Bouwense; Hjalmar C van Santvoort; Harry van Goor Journal: Surg Endosc Date: 2013-09-06 Impact factor: 4.584
Authors: Catherine J Yang; Lindsay A Bliss; Emily F Schapira; Steven D Freedman; Sing Chau Ng; John A Windsor; Jennifer F Tseng Journal: J Gastrointest Surg Date: 2014-06-19 Impact factor: 3.452
Authors: Maria G Sacco Casamassima; Seth D Goldstein; Jingyan Yang; Colin D Gause; Fizan Abdullah; Avner Meoded; Martin A Makary; Paul M Colombani Journal: Pediatr Surg Int Date: 2016-11-04 Impact factor: 1.827
Authors: Varvara A Kirchner; Ty B Dunn; Gregory J Beilman; Srinath Chinnakotla; Timothy L Pruett; Joshua J Wilhelm; Sarah J Schwarzenberg; Martin L Freeman; Melena D Bellin Journal: Curr Treat Options Gastroenterol Date: 2017-12
Authors: A Merdrignac; D Bergeat; F Robin; E Gaignard; K Turner; M Rayar; B Meunier; K Boudjema; Laurent Sulpice Journal: Langenbecks Arch Surg Date: 2019-10-25 Impact factor: 3.445