Beger and Frey procedures for treatment of chronic pancreatitis: comparison of outcomes at 16-year follow-up

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Kai Bachmann - , University Hospital Hamburg Eppendorf (Author)
  • Lena Tomkoetter - , University Hospital Hamburg Eppendorf (Author)
  • Johannes Erbes - , University Hospital Hamburg Eppendorf (Author)
  • Bianca Hofmann - , University Hospital Hamburg Eppendorf (Author)
  • Matthias Reeh - , University Hospital Hamburg Eppendorf (Author)
  • Daniel Perez - , University Hospital Hamburg Eppendorf (Author)
  • Yogesh Vashist - , University Hospital Hamburg Eppendorf (Author)
  • Maximilian Bockhorn - , University Hospital Hamburg Eppendorf (Author)
  • Jakob R Izbicki - , University Hospital Hamburg Eppendorf (Author)
  • Oliver Mann - , University Hospital Hamburg Eppendorf (Author)

Abstract

BACKGROUND: Chronic pancreatitis is a chronic inflammatory disorder characterized by progressive fibrosis of pancreatic tissue. The principal symptom is chronic pain resulting in reduced quality of life and inability to work. Short-term follow-up has shown that duodenum-preserving pancreatic head resections (DPPHRs) are superior in outcomes to pancreaticoduodenectomy. Therefore, these organ-sparing procedures have gained wide acceptance. This trial was conducted to compare patient outcomes 16 years after treatment for chronic pancreatitis by means of the Beger or the Frey procedure.

STUDY DESIGN: Seventy-four patients suffering from chronic pancreatitis were randomly assigned to 2 treatment groups (Beger n = 38) and Frey (n = 36). The perioperative courses in the randomized controlled trial and the 8-year follow-up have been reported previously. All participating patients were contacted with a standardized, validated questionnaire to evaluate long-term survival, quality of life, pain, and exocrine and endocrine function.

RESULTS: No significant differences between the 2 groups in terms of quality of life, pain control, or other somatic parameters were detected after a median of 16 years postoperatively. Mortality was comparable after Beger and Frey procedures at 39% vs 34%, respectively, with postoperative survivals of 13.0 ± 1.1 years and 13.3 ± 0.9 years, respectively (p = 0.660). No statistically significant differences were found in rates of endocrine insufficiency (Beger 87% vs Frey 86%; p = 0.953) or exocrine insufficiency (Beger 77% vs Frey 83%; p = 0.655).

CONCLUSIONS: Duodenum-preserving resections of the pancreatic head offered good and permanent pain relief and substantially increased quality of life in chronic pancreatitis. Overall, a 16-year long-term follow-up found comparable outcomes for the Beger and Frey procedures.

Details

Original languageEnglish
Pages (from-to)208-216
Number of pages9
JournalJournal of the American College of Surgeons : JACS
Volume219
Issue number2
Publication statusPublished - Aug 2014
Peer-reviewedYes
Externally publishedYes

External IDs

Scopus 84904690745

Keywords

Keywords

  • Adult, Drainage, Female, Follow-Up Studies, Humans, Male, Pain Measurement, Pancreatic Function Tests, Pancreaticojejunostomy/methods, Pancreatitis, Chronic/surgery, Quality of Life, Surveys and Questionnaires, Survival Rate, Treatment Outcome

Library keywords