Document Detail


Resection vs drainage in treatment of chronic pancreatitis: long-term results of a randomized trial.
MedLine Citation:
PMID:  18471517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Tailored organ-sparing procedures have been shown to alleviate pain and are potentially superior in terms of preservation of endocrine and exocrine function as compared with standard resection (Whipple) for chronic pancreatitis with inflammatory pancreatic head tumor. Long-term results comparing these 2 procedures have not been published so far. The aim of this study was to report on long-term results of a randomized trial comparing a classical resective procedure (pylorus-preserving Whipple) with an extended drainage procedure (Frey) for chronic pancreatitis. METHODS: All patients who participated in a previously published randomized trial on the perioperative course comparing both procedures were contacted with a standardized, validated, quality of life and pain questionnaire. Additionally, patients were seen in the outpatient clinic to assess endocrine and exocrine pancreatic function by an oral glucose tolerance test and fecal chymotrypsin test. RESULTS: There were no differences between both groups regarding quality of life, pain control, or other somatic parameters after a median of 7 years postoperatively. Correlations among continuous alcohol consumption, endocrine or exocrine pancreatic function, and pain were not found. CONCLUSIONS: Both procedures provide adequate pain relief and quality of life after long-term follow-up with no differences regarding exocrine and endocrine function. However, short-term results favor the organ-sparing procedure.
Authors:
Tim Strate; Kai Bachmann; Philipp Busch; Oliver Mann; Claus Schneider; Jens P Bruhn; Emre Yekebas; Thomas Kuechler; Christian Bloechle; Jakob R Izbicki
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-03-04
Journal Detail:
Title:  Gastroenterology     Volume:  134     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-12     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1406-11     Citation Subset:  AIM; IM    
Affiliation:
Department of General Surgery, University Hospital Hamburg Eppendorf, Hamburg, Germany. strate@uke.uni-hamburg.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Glucose / metabolism
Chymotrypsin / metabolism
Drainage / methods*
Feces / chemistry
Female
Follow-Up Studies
Germany / epidemiology
Humans
Male
Middle Aged
Pancreaticoduodenectomy / methods*
Pancreatitis, Chronic / metabolism,  mortality,  surgery*
Quality of Life
Questionnaires
Retrospective Studies
Survival Rate / trends
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Glucose; EC 3.4.21.1/Chymotrypsin
Comments/Corrections
Comment In:
Gastroenterology. 2008 May;134(5):1605-7   [PMID:  18471528 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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