Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis
Objective:. To study the impact of pancreaticoscopy during Frey’s procedure for treating chronic pancreatitis (CP). Background:. Excision of the central part of the head of the pancreas along with longitudinal pancreaticotomy (Frey’s procedure) is widely performed for the treatment of CP. However, t...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2021-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000106 |
| _version_ | 1797732832848642048 |
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| author | Alexander E. Julianov, MD, PhD, FACS Azize S. Saroglu, MD |
| author_facet | Alexander E. Julianov, MD, PhD, FACS Azize S. Saroglu, MD |
| author_sort | Alexander E. Julianov, MD, PhD, FACS |
| collection | DOAJ |
| description | Objective:. To study the impact of pancreaticoscopy during Frey’s procedure for treating chronic pancreatitis (CP).
Background:. Excision of the central part of the head of the pancreas along with longitudinal pancreaticotomy (Frey’s procedure) is widely performed for the treatment of CP. However, there is no reliable method to determine the necessary length of longitudinal pancreaticotomy during surgery for CP.
Methods:. Thirty-five consecutive patients with CP were scheduled for Frey’s procedure with intraoperative pancreaticoscopy. The length of the longitudinal pancreaticotomy was tailored by pancreaticoscopy in the following manner: (1) it did not extend beyond the neck in case of a uniformly dilated main duct with patent branch duct confluences and a clear lumen; (2) in case of an obstructed main duct or branch duct confluence of any cause, the main duct was opened to include the most distal obstruction.
Results:. All patients underwent Frey’s procedure and intraoperative pancreaticoscopy. Based on the pancreaticoscopy findings, pancreaticotomy over the body of the gland was not necessary in 34% of the patients. A short (4–6 cm) ductotomy extension over the pancreatic body was required in 14% of the patients. Full-length pancreaticotomy was required in 52% of the patients. The median operative time was 145 minutes, and the median blood loss was 70 mL. Four patients (11.4%) experienced postoperative complications. There were no 90-day postoperative mortality or hospital readmission rates. At the median follow-up of 19 months, 31 patients (88.5%) had no pain attacks requiring medication.
Conclusions:. Intraoperative pancreaticoscopy helps to determine the length of longitudinal pancreaticotomy and reduce pancreatic trauma during Frey’s procedure for treating CP. |
| first_indexed | 2024-03-12T12:20:14Z |
| format | Article |
| id | doaj.art-fdae3ffb466c4a16bd83521173155213 |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2024-03-12T12:20:14Z |
| publishDate | 2021-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-fdae3ffb466c4a16bd835211731552132023-08-30T06:09:12ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932021-12-0124e10610.1097/AS9.0000000000000106202112000-00007Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic PancreatitisAlexander E. Julianov, MD, PhD, FACS0Azize S. Saroglu, MD1From the Department of Surgery, Trakia Hospital, Stara Zagora, Bulgaria.From the Department of Surgery, Trakia Hospital, Stara Zagora, Bulgaria.Objective:. To study the impact of pancreaticoscopy during Frey’s procedure for treating chronic pancreatitis (CP). Background:. Excision of the central part of the head of the pancreas along with longitudinal pancreaticotomy (Frey’s procedure) is widely performed for the treatment of CP. However, there is no reliable method to determine the necessary length of longitudinal pancreaticotomy during surgery for CP. Methods:. Thirty-five consecutive patients with CP were scheduled for Frey’s procedure with intraoperative pancreaticoscopy. The length of the longitudinal pancreaticotomy was tailored by pancreaticoscopy in the following manner: (1) it did not extend beyond the neck in case of a uniformly dilated main duct with patent branch duct confluences and a clear lumen; (2) in case of an obstructed main duct or branch duct confluence of any cause, the main duct was opened to include the most distal obstruction. Results:. All patients underwent Frey’s procedure and intraoperative pancreaticoscopy. Based on the pancreaticoscopy findings, pancreaticotomy over the body of the gland was not necessary in 34% of the patients. A short (4–6 cm) ductotomy extension over the pancreatic body was required in 14% of the patients. Full-length pancreaticotomy was required in 52% of the patients. The median operative time was 145 minutes, and the median blood loss was 70 mL. Four patients (11.4%) experienced postoperative complications. There were no 90-day postoperative mortality or hospital readmission rates. At the median follow-up of 19 months, 31 patients (88.5%) had no pain attacks requiring medication. Conclusions:. Intraoperative pancreaticoscopy helps to determine the length of longitudinal pancreaticotomy and reduce pancreatic trauma during Frey’s procedure for treating CP.http://journals.lww.com/10.1097/AS9.0000000000000106 |
| spellingShingle | Alexander E. Julianov, MD, PhD, FACS Azize S. Saroglu, MD Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis Annals of Surgery Open |
| title | Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis |
| title_full | Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis |
| title_fullStr | Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis |
| title_full_unstemmed | Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis |
| title_short | Determination of the Length of Pancreatic Ductotomy by Pancreaticoscopy During Frey’s Procedure for Chronic Pancreatitis |
| title_sort | determination of the length of pancreatic ductotomy by pancreaticoscopy during frey s procedure for chronic pancreatitis |
| url | http://journals.lww.com/10.1097/AS9.0000000000000106 |
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