Frey's procedure
Encyclopedia
Frey's procedure is a surgical
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 technique used in the treatment of chronic pancreatitis
Pancreatitis
Pancreatitis is inflammation of the pancreas. It occurs when pancreatic enzymes that digest food are activated in the pancreas instead of the small intestine. It may be acute – beginning suddenly and lasting a few days, or chronic – occurring over many years...

 in which the diseased portions of the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

 head are cored out. A lateral pancreaticojejunostomy (LRLPJ) is then performed in which a loop of the jejunum
Jejunum
The jejunum is the middle section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms middle intestine or mid-gut may be used instead of jejunum.The jejunum lies between the duodenum...

 is then mobilized and attached over the exposed pancreatic duct
Pancreatic duct
The pancreatic duct, or duct of Wirsung , is a duct joining the pancreas to the common bile duct to supply pancreatic juices which aid in digestion provided by the "exocrine pancreas"...

 to allow better drainage of the pancreas, including its head.

Indication

Frey's operation is indicated
Indication (medicine)
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. The opposite of indication is contraindication.-Drugs:...

 on patients with chronic pancreatitis who have "head dominant" disease.

Comparison to Puestow procedure

Compared with a Puestow procedure
Puestow procedure
The Puestow procedure is a surgical technique used in the treatment of chronic pancreatitis...

, a Frey's procedure allows for better drainage of the pancreatic head.

Complications

Postoperative complications after LRLPJ are usually septic
Sepsis
Sepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...

 in nature and are likely to occur more often in patients in whom endoscopic pancreatic stent
Stent
In the technical vocabulary of medicine, a stent is an artificial 'tube' inserted into a natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction. The term may also refer to a tube used to temporarily hold such a natural conduit open to allow...

ing has been performed before surgical intervention. Pancreatic endocrine insufficiency occurs in 60% of patients.

Additional reading


External links

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