Pancreatic Disorders & Therapy
Open Access

Abstract

Long-Term Outcome Following Frey?s Procedure-A Single-Centre Experience

Vimalakar Reddy Eppa, Raju Musham, Gayatri Senapathy, V Ganta

Introduction: Chronic pancreatitis is a crippling, progressive inflammatory disease of the pancreas associated with excruciating abdominal pain and exocrine and endocrine insufficiency, leading to poor quality of life, emotional stress and financial burden. The main indication for surgical intervention is intractable pain. Frey’s procedure is the most preferred procedure. Objectives: The purpose of this study is to assess long-term pain management in patients with chronic pancreatitis who underwent Frey’s procedure using a validated pain score, as well as exocrine and endocrine insufficiencies and quality of life. Methods: This is a prospectively analyzed retrospective study done at KIMS-Sunshine Hospital, Secunderabad. 48 patients who underwent Frey’s procedure between 2016 and 2021 with a minimum 1-year follow-up were analyzed using validated pain score used by Izbicki pain score, exocrine and endocrine funtions, quality of life (SF-6) and nutritional status was analyzed in terms of steatorrhea, glycaemic control and weight gain. Results: The total number of patients enrolled was 52. Four patients were identified intraoperatively as having malignancy by frozen section and were therefore converted to the Whipple procedure. So, 48 (30=male, 18=female, mean age was 35.2 years) patients were analyzed in this study. 6 patients underwent hepaticojejunostomy along with Frey’s procedure in view of benign biliary stricture. 18 (37.5%) out of 48 patients had previously undergone pancreatic duct stenting multiple times elsewhere. In the study of 48 patients with a preoperative mean overall pain score of 66.67, in comparison, the postoperative mean overall pain score at 3 months, 1 year, 3 years and at 5 years were found to be 6.27, 6.37, 8.26 and 8.42 respectively, here demonstrating an unequivocal and statistically significant (p<0.05) pain reduction in both short term and long-term. In the 18 patients who had previous stenting, the pain scores were compared prior to and after surgery using propensity matching. In the first 3 months following surgery, there was weight gain in most of the patients (65%). though some patients showed mild weight loss subsequently on long-term follow-up, it was not statistically significant (p-value-0.041). Steatorrhea which was seen in 25 (52%) patients preoperatively was persistent following surgery. Additionally, 5 new patients developed steatorrhea on follow-up

Published Date: 2025-02-20;