Combination of longitudinal pancreaticojejunostomy with coring-out of the pancreatic head (Frey procedure) and distal pancreatectomy for chronic pancreatitis
The Frey procedure is an effective surgery for chronic pancreatitis (CP) patients who have pancreatic head lesions with dilation of the main pancreatic duct. However, pancreatic tail lesions can cause relapsing pancreatitis after the procedure. Therefore, additional distal pancreatectomy (DP) might complement the therapeutic effect of the Frey procedure in controlling inflammation of the pancreatic tail. The Frey procedure with DP (Frey + DP) is indicated for inflammatory lesions in the pancreatic head and tail. In this study, we assessed the usefulness of Frey + DP using the retrospective clinical data of our cases.
The clinical outcomes were compared between CP patients who underwent the Frey procedure (N = 44) and Frey + DP (N = 13) from January 2005 to April 2016.
Frey + DP showed similarly good therapeutic effects to the Frey procedure with regard to the postoperative stay, morbidity, mortality, pain relief and nutrition, although the Frey + DP had a longer operative time, more bleeding and higher incidence of diabetes mellitus than the Frey procedure because of the additional DP. One patient in the Frey group received additional DP because of recurrent pain due to the tail lesion.
Frey + DP can be a promising treatment for CP patients with pancreatic head and tail lesions.
KeywordsChronic pancreatitis Frey procedure Distal pancreatectomy
Compliance with ethical standards
Conflict of interest
Hideaki Sato and the other co-authors have no conflicts of interest to declare in association with this study.
- 1.The Japanese Society of Gastroenterology. Evidence-based clinical practice guidelines for chronic pancreatitis 2015. 2nd edn. Nankodo: The Japanese Society of Gastroenterology; 2015 (in Japanese).Google Scholar
- 3.Puestow CW, Gillesby WJ. Retrograde surgical drainage of the pancreas for chronic relapsing pancreatitis. Ann Surg. 1958;69:898–907.Google Scholar
- 6.Izbicki JR, Bloechle C, Broering DC, Knoefel WT, Kuechler T, Broelsch CE. Extended drainage versus resection in surgery for chronic pancreatitis: a prospective randomized trial comparing the longitudinal pancreaticojejunostomy combined with local pancreatic head excision with the pylorus-preserving pancreatoduodenectomy. Ann Surg. 1998;228:771–9.CrossRefGoogle Scholar