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Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial.

Abstract：

OBJECTIVE:Two techniques of duodenum-preserving resection of the head of the pancreas were compared in a prospective, randomized trial. The technical feasibility and effects on quality of life were assessed. SUMMARY BACKGROUND DATA:Drainage and resection are the principles of surgery in chronic pancreatitis. The techniques of duodenum-preserving resection of the head of the pancreas as described by Berger and Frey combine both to different degrees. The efficacy of both procedures has not been compared thus far. METHODS:Forty-two patients were allocated randomly to either Beger's (n = 20) or Frey's (n = 22) group. In addition to routine pancreatic diagnostic work-up, a multidimensional psychometric quality-of-life questionnaire and and a pain score were used. Assessment of endocrine and exocrine function included oral glucose tolerance test, serum concentrations of insulin, C-peptide, and HbA1c, as well as fecal chymotrypsin and pancreolauryl test. The interval between symptoms and surgery ranged from 12 months to 12 years, with a mean of 5.7 years. The mean follow-up was 1.5 years. RESULTS:There was no mortality. Overall morbidity was 14% (20% Beger, 9% Frey). Complications from adjacent organs were resolved definitively in 94% (90% Beger, 100% Frey). A decrease of 95% and 94% of the pain score after Beger's and Frey's procedure, respectively, and an increase of 67% of the overall quality-of-life index in both groups were observed. Endocrine and exocrine function did not differ between both groups. CONCLUSIONS:Both techniques of duodenum-preserving resection of the head of the pancreas are equally safe and effective with regard to pain relief, improvement of quality of life, and definitive control of complications affecting adjacent organs. Neither procedure leads to further deterioration of endocrine and exocrine pancreatic function.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Izbicki JR,Bloechle C,Knoefel WT,Kuechler T,Binmoeller KF,Broelsch CE

doi

10.1097/00000658-199504000-00004

subject

Has Abstract

pub_date

1995-04-01 00:00:00

pages

350-8

issue

eissn

0003-4932

issn

1528-1140

journal_volume

221

pub_type

临床试验,杂志文章,随机对照试验

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Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial.