November 12, 2014
Notes: Carrasco, Cristina
Marchena, Ana M
Holguin-Arevalo, Maria S
Rodriguez, Ana B
Paredes, Sergio D
Pariente, Jose A
Research Support, Non-U.S. Gov’t
Cell Biochem Funct. 2013 Oct;31(7):585-90. doi: 10.1002/cbf.2942.
Reference Type: Journal Article
Record Number: 4629Author: Cauchy, F., Regimbeau, J. M., Fuks, D., Balladur, P., Tiret, E. and Paye, F.
Title: Influence of bile duct obstruction on the results of Frey’s procedure for chronic pancreatitis
Short Title: Influence of bile duct obstruction on the results of Frey’s procedure for chronic pancreatitis
Alternate Journal: Pancreatology : official journal of the International Association of Pancreatology
ISSN: 1424-3911 (Electronic)
Accession Number: 24555975
Abstract: OBJECTIVES: To evaluate the influence of a biliary obstruction (BO) requiring biliary bypass on both short and long-term outcomes of patients undergoing Frey’s procedure for chronic pancreatitis (CP). METHODS: From 1999 to 2010, 33 consecutive patients underwent Frey’s procedure for CP in two centers. Seventeen (54%) patients underwent biliary bypass to treat an associated BO. Characteristics and outcomes of these patients were compared to those of 16 others without BO. RESULTS: Patients with BO had more severe disease including lower BMI and larger pancreatic head (4 cm vs. 6 cm, p = 0.021). The operative mortality was nil. Patients with BO experienced more overall postoperative complications (71% vs. 31%, p = 0.024) but similar major complication rates (18% vs. 6%, p = 0.316) compared to those without BO. After a median follow-up of 51 (1-96) months, 91% of the patients experienced either partial or complete relief of their symptoms and 36% exhibited deterioration of their endocrine function. Multivariate analysis revealed preoperative BO to be associated with long-term impairment of endocrine function (OR: 43.249; 95% CI 2.221-84.277; p = 0.013). CONCLUSION: In patients undergoing Frey’s procedure for CP, associated BO can be safely managed using biliary bypass. However, the severity of CP in these patients is responsible for a higher risk of long-term endocrine insufficiency.