SURGERY FOR CHRONIC-PANCREATITIS - EXTENDED PANCREATICOJEJUNOSTOMY

Background/Aims: The role of Frey's operation as extended pancreatic d uct drainage operation was evaluated in patients with chronic pancreat itis. Methodology: 206 patients with chronic pancreatitis were surgica lly treated, evaluated and followed for a minimum period of 6 months, in order to ascertain the status of pancreatic function and pain relie f for both pancreatic duct drainage operations, including Frey's opera tion, and pancreatectomy. Results: Pain relief was established in 62 o ut to 86 patients (72.1%) undergoing pancreas duct drainage operation, in 51 out of 65 patients (78.5%) undergoing pancreatectomy. Fourteen out of 16 patients undergoing standard pancreaticojejunostomy with eit her persistant or alleviated pain had impacted calculi or peudocysts i n the pancreatic head an uncinate process preoperatively. Seventeen pa tients (16.3%) maintained normal glucose tolerance. Improvement was no ted in 15 patients (14.4%) and in 27 patients the condition worsened ( 26.0%). The 10 years survival ratio in patients with diabetes mellitus preoperatively was 67.5% significantly lower than in patients without diabetes mellitus, 81.3% (p = 0.0029). Frey's operation was performed in 11 patients, providing satisfactory pain relief and preserving pan creatic exocrine and endocrine function. Conclusions: Frey's procedure should be considered as a new standard procedure in patients with pan creatic head complications and ductal dilatation in chronic pancreatit is.