Frey's procedure is a
surgical
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
technique used in the treatment of chronic
pancreatitis
Pancreatitis is a condition characterized by inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types: acute pancreatitis, and chronic pancr ...
in which the diseased portions of the
pancreas
The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an end ...
head are cored out. A lateral pancreaticojejunostomy (LRLPJ) is then performed in which a
loop of the jejunum is then mobilized and attached over the exposed
pancreatic duct
The pancreatic duct, or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct), is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancre ...
to allow better drainage of the pancreas, including its head.
Indication
Frey's operation is
indicated
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis ...
on patients with chronic pancreatitis who have "head dominant" disease.
Comparison to Puestow procedure
Compared with a
Puestow procedure
The Puestow procedure (also known as a Puestow-Gillesby procedure, or a lateral pancreaticojejunostomy) is a surgical technique used in the treatment of chronic pancreatitis. It involves a side-to-side anastomosis of the pancreatic duct and the jej ...
, a Frey's procedure allows for better drainage of the pancreatic head.
Complications
Postoperative complications after LRLPJ are usually
septic in nature and are likely to occur more often in patients in whom endoscopic pancreatic
stent
In medicine, a stent is a metal or plastic tube inserted into the lumen of an anatomic vessel or duct to keep the passageway open, and stenting is the placement of a stent. A wide variety of stents are used for different purposes, from expandab ...
ing has been performed before surgical intervention. Pancreatic endocrine insufficiency occurs in 60% of patients.
Eponym
It is named for the American surgeon Charles Frederick Frey (b.1929) of Michigan, who first described it in 1987. Dr Frey died on February 7, 2022
References
Further reading
* Bapat RD, Satish R R, Kantharia CV. Choice Of Surgical Procedures for Chronic Pancreatitis. Bombay Hospital Journal. January 2001. Available at
https://web.archive.org/web/20120207122247/http://www.bhj.org/journal/2001_4301_jan/reviews_175.htm Accessed on: October 15, 2007.
External links
Frey's procedure (drawing)- Bombay Hospital Journal.
{{Digestive system surgical procedures
Accessory digestive gland surgery