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• W3199191989 abstract "Presenter: Savannah R Smith MD | Emory University Background: Intractable pain refractory to medical management is an indication for surgery in chronic pancreatitis. The Frey and Whipple procedures are proven interventions especially if the disease is proximal (pancreatic head). In spite of that, there are limited data on the immediate and long term postoperative outcomes in these patients Methods: The authors conducted a retrospective analysis of consecutive patients who underwent surgical intervention for chronic pancreatitis of the pancreatic head or proximal pancreas from 2003 to 2019 at a large tertiary care center. Preoperative patient characteristics and 30-day postoperative outcomes, including symptoms and complications, were evaluated. Whipple procedure was elected for those patients with inflammatory masses in the head of the pancreas and involvement of uncinate process. Frey procedure was selected for patients with a dilated distal duct (even more if “chain of lakes”) and deformity or inflammatory mass in the head of the pancreas Results: Ninety-one patients underwent a Whipple, and 52 underwent local resection of the pancreatic head with lateral pancreaticojejunostomy (Frey). The median age at time of surgical intervention was 54 (range 45 – 63), 60% were male. Median BMI was 23.5 (20 – 28) kg/m2. Median length of hospital stay was 7 days for both procedures. The majority of patients (62%) had a significant smoking history within one year of operation, and 42% of all patients had a history of alcohol use within one year of operation. The most common presenting symptom was pain. Operative time for Whipple was 224 (±104) minutes compared to 146 (±40) for Frey. Eighteen percent of patients experienced Clavien III or IV complications within the first 30 postoperative days, and 7% of all patients developed a pancreatic leak postoperatively, with 5% being clinically significant pancreatic leaks. 73% of patients experienced symptomatic resolution at the time of post-operative visit (within one month of operation), and nearly 80% of patients remained symptom-free at median follow-up of 3 months postoperatively. Conclusion: Both Whipple and Frey procedures are appropriate options for management in chronic pancreatitis, especially those limited proximally in the pancreas. Both operations lead to resolution of symptoms for the vast majority of patients within the first 30 days post-operatively. Most patients undergo pre-operative nonsurgical management; surgery, when indicated, is a valid strategy for management of these refractory patients." @default.
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• W3199191989 date "2021-01-01" @default.
• W3199191989 modified "2023-09-27" @default.
• W3199191989 title "Long term outcomes of surgical management of chronic pancreatitis: results from a contemporary series" @default.
• W3199191989 doi "https://doi.org/10.1016/j.hpb.2021.06.291" @default.
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