This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Pain relief after Frey’s procedure for chronic pancreatitis. BJS 2010; 97: 1087-1095.
Published: 19th April 2010
Authors: S. Negi, A. Singh, A. Chaudhary
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.
Method
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 © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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