Background

Longitudinal pancreatojejunostomy with partial pancreatic head resection (the Frey procedure) is accepted for surgical treatment of painful chronic pancreatitis. However, conduct and reporting are not standardized and thus, making comparisons difficult. This study assesses the reporting standards of this procedure.

Data sources

A systematic literature review was performed between January 1987 and January 2020. The keyword and Medical Subject Heading “chronic pancreatitis” was used together with the individual operation term “Frey pancreatojejunostomy”. Reports were included if they provided original information on conduct and outcome. Thirty-three papers providing information on 1205 patients constituted the study population. Risk of bias in included reports was assessed.

Results

Etiology of chronic pancreatitis (alcohol) was reported in 26 of 28 (93%) studies, duration of symptoms prior to surgery in 19 (58%) studies and pre-operative opiate use in 12 (36%) studies. In terms of morphology, pancreatic duct diameter was reported in 17 (52%) studies and diameter of the pancreatic head in 13 (39%) studies. In terms of technique, three (9%) studies reported weight of excised parenchyma. There were 9 (0.7%) procedure-related deaths. Post-operative follow-up ranged from 6 to 82.5 months. No studies reported post-operative portal hypertension.

Conclusions

There is substantial heterogeneity between studies in reporting of clinical baseline, morphology of the diseased pancreas, operative detail and outcome after longitudinal pancreatojejunostomy with partial pancreatic head resection. This critically compromises the comparison between centers and between surgeons. Structured reporting is necessary for clinicians to assess choice of procedure and for patients to make informed choices when seeking treatment for painful chronic pancreatitis.

中文翻译：

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慢性胰腺炎部分胰头切除术（Frey 手术）的纵向胰腺空肠吻合术的报告：系统评价

背景

部分胰头切除术（Frey 手术）的纵向胰腺空肠吻合术被接受用于疼痛性慢性胰腺炎的手术治疗。但是，行为和报告没有标准化，因此比较困难。本研究评估了该程序的报告标准。

数据源

在 1987 年 1 月至 2020 年 1 月期间进行了系统文献回顾。关键字和医学主题词“慢性胰腺炎”与个体手术术语“Frey pancreatojejunostomy”一起使用。如果报告提供了有关行为和结果的原始信息，则包括在内。提供 1205 名患者信息的 33 篇论文构成了研究人群。评估了纳入报告的偏倚风险。

结果

28 项研究中有 26 项 (93%) 报告了慢性胰腺炎（酒精）的病因，19 项 (58%) 研究报告了手术前症状的持续时间，12 项 (36%) 研究报告了术前使用阿片类药物。在形态学方面，17 项 (52%) 研究报告了胰管直径，13 项 (39%) 研究报告了胰头直径。在技​​术方面，三项 (9%) 研究报告了切除的实质的重量。有 9 例（0.7%）与手术相关的死亡。术后随访时间为 6 至 82.5 个月。没有研究报告术后门静脉高压症。

结论

在报告临床基线、患病胰腺的形态、手术细节和纵向胰腺空肠吻合术和部分胰头切除术后的结果方面，研究之间存在很大的异质性。这严重影响了中心之间和外科医生之间的比较。结构化报告对于临床医生评估手术选择以及患者在寻求治疗疼痛性慢性胰腺炎时做出明智的选择是必要的。