Predictors of Post-Operative Pain Relief in Patients with Chronic Pancreatitis Undergoing the Frey or Whipple Procedure

Amitasha Sinha, Yuval A. Patel, Michael Cruise, Karen Matsukuma, Atif Zaheer, Elham Afghani, Dhiraj Yadav, Martin A. Makary, Kenzo Hirose, Dana K. Andersen, Vikesh K. Singh

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Post-operative pain relief in chronic pancreatitis (CP) is variable. Our objective was to determine clinical imaging or histopathologic predictor(s) of post-operative pain relief in CP patients undergoing the Whipple or Frey procedure. Methods: All patients who underwent a Whipple (n = 30) or Frey procedure (n = 30) for painful CP between January 2003 and September 2013 were evaluated. A toxic etiology was defined as a history of alcohol use and/or smoking. The pre-operative abdominal CT was evaluated for calcification(s) and main pancreatic duct (MPD) dilation (≥5 mm). The post-operative histopathology was evaluated for severe fibrosis. Clinical imaging and histopathologic features were evaluated as predictors of post-operative pain relief using univariable and multivariable regression analysis. Results: A total of 60 patients (age 51.6 years, 53 % males) were included in our study, of whom 42 (70 %) reported post-operative pain relief over a mean follow-up of 1.1 years. There were 37 (62 %) patients with toxic etiology, 36 (60 %) each with calcification(s) and MPD dilation. A toxic etiology, calcifications, and severe fibrosis were associated with post-operative pain relief on univariable analysis (all p < 0.01). However, only a toxic etiology was an independent predictor of post-operative pain relief (OR 5.7, 95 % CI 1.3, 24.5, p = 0.02). Conclusion: Only a toxic etiology, and not imaging or histopathologic findings, independently predicts post-operative pain relief in CP patients undergoing the Whipple or Frey procedure.

Original languageEnglish (US)
Pages (from-to)734-740
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Keywords

  • Alcohol
  • Chronic pancreatitis
  • Post-operative pain relief
  • Smoking

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Sinha, A., Patel, Y. A., Cruise, M., Matsukuma, K., Zaheer, A., Afghani, E., Yadav, D., Makary, M. A., Hirose, K., Andersen, D. K., & Singh, V. K. (2016). Predictors of Post-Operative Pain Relief in Patients with Chronic Pancreatitis Undergoing the Frey or Whipple Procedure. Journal of Gastrointestinal Surgery, 20(4), 734-740. https://doi.org/10.1007/s11605-016-3081-7