Beger's operation and the Berne modification: origin and current results

BACKGROUND Abdominal pain in chronic pancreatitis (CP) may require invasive interventions. Surgical procedures are rare, and little is known about the long-term results. AIM To study the nationwide frequency of pancreatic surgery for CP in Finland, and postoperative symptoms and quality of life (QoL). METHODS All patients in Finland with a diagnosis of CP who had undergone pancreatic surgery during 2000-2008 were selected from a national register. Only patients with CP as an indication for pancreatic surgery were included. Medical records were studied and questionnaires QLQ-C30, PAN26 and AUDIT, and symptom questionnaires were sent out. RESULTS During the 9-year period, pancreatic surgery for CP was performed on 30 patients [77% men, median age 45 (21-62) years]. Eighty-three percent underwent endoscopic procedures before surgery. Surgery was performed a median 2 (0-10) years after the original CP diagnosis, and 17% developed postoperative complications. Primary pain relief after surgery was reported in 70% of cases. Need for strong pain medication was lower after surgery. Eight of 21 (38%) returned the questionnaires and 88% reported that surgery had reduced their pain and 63% were almost or entirely pain-free at a median 14 (10-18) years after surgery. QoL results did not differ from those in our control Finnish CP group. CONCLUSION Surgery for CP is rare in Finland and most patients had prior endoscopic procedures. Patients who returned the questionnaires reported less pain and good QoL during the 14-year follow-up.

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“…QLQ-C30, PAN-26[ 24 ] and AUDIT questionnaires and a nonstandardized questionnaire about pain before and after surgery were sent to the patients.…”

Section: Methodsmentioning

confidence: 99%

Surgery for chronic pancreatitis in Finland is rare but seems to produce good long-term results

Parhiala¹,

Sand²,

Laukkarinen³

2021

WJCC

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“…DPPHRs (ie, Beger, Berne, Frey procedures) have gained significant popularity as alternatives to pancreaticoduodenectomy in CP patients with an inflammatory head mass as they offer the benefits of preserving the duodenum and the bile duct, limiting the extent of pancreatic parenchymal resection, and significantly lowering overall morbidity and gastrointestinal complications compared with pancreaticoduodenectomy (81). DPPHRs are most effective when performed by experienced pancreatic surgeons in patients with CP and an inflammatory pancreatic head mass.…”

Section: Outcomes Following Operations For Chronic Pancreatitismentioning

confidence: 99%

The Role of Surgical Management in Chronic Pancreatitis in Children

Nathan¹,

Ellery²,

Balakrishnan³

et al. 2022

J. pediatr. gastroenterol. nutr.

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Objectives:Chronic pancreatitis (CP) is rare in childhood but impactful because of its high disease burden. There is limited literature regarding the management of CP in children, specifically about the various surgical approaches. Herein, we summarize the current pediatric and adult literature and provide recommendations for the surgical management of CP in children.Methods:The literature review was performed to include the scope of the problem, indications for operation, conventional surgical options as well as total pancreatectomy with islet autotransplantation, and outcomes following operations for CP.Results:Surgery is indicated for children with debilitating CP who have failed maximal medical and endoscopic interventions. Surgical management must be tailored to the patient's unique needs, considering the anatomy and morphology of their disease. A conventional surgical approach (eg, drainage operation, partial resection, combination drainage-resection) may be considered in the presence of significant and uniform pancreatic duct dilation or an inflammatory head mass. Total pancreatectomy with islet autotransplantation is the best surgical option in patients with small duct disease. The presence of genetic risk factors often portends a suboptimal outcome following a conventional operation.Conclusions:The morphology of disease and the presence of genetic risk factors must be considered while determining the optimal surgical approach for children with CP. Surgical outcomes for CP are variable and depend on the type of intervention. A multidisciplinary team approach is needed to assure that the best possible operation is selected for each patient, their recovery is optimized, and their immediate and long-term postoperative needs are well-met.

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“…The metabolic complications are reduced as well as survival rates. Furthermore, the Berne procedure is easier to perform than the Beger procedure [ 31 , 35 ].…”

Section: Establishing Techniques For Chronic Pancreatitismentioning

confidence: 99%

Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future

Plagemann

Welte

Izbicki

et al. 2017

Gastroenterology Research and Practice

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The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment. Although surgical procedures have become safer and more efficient than ever, the overall perioperative morbidity after pancreatic surgery remains high and management of postoperative complications stagnates. Current research focuses on the prevention of complications, optimizing the patient's general condition preoperatively and finding the appropriate timing for surgical treatment.

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Beger's operation and the Berne modification: origin and current results

Cited by 10 publications

References 72 publications

Surgery for chronic pancreatitis in Finland is rare but seems to produce good long-term results

Surgery for chronic pancreatitis in Finland is rare but seems to produce good long-term results

The Role of Surgical Management in Chronic Pancreatitis in Children

Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future

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