Frey's procedure

Pancreas

Frey's procedure is a surgical technique used in the treatment of chronic pancreatitis in which the diseased portions of the pancreas 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 to allow better drainage of the pancreas, including its head.^[1]

Indication

Frey's operation is indicated on patients with chronic pancreatitis who have "head dominant" disease.

Comparison to Puestow procedure

Compared with a Puestow procedure, 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 stenting has been performed before surgical intervention.^[2] Pancreatic endocrine insufficiency occurs in 60% of patients.

Eponym

It is named for the American surgeon C. F. Frey, who together with G. J. Smith first described it in 1987.^[3]

References

↑ Gourgiotis S, Germanos S, Ridolfini MP (2007). "Surgical management of chronic pancreatitis". Hbpd Int 6 (2): 121–33. PMID 17374569.
↑ Chaudhary A, Negi SS, Masood S, Thombare M (2004). "Complications after Frey's procedure for chronic pancreatitis". Am. J. Surg. 188 (3): 277–281. doi:10.1016/j.amjsurg.2004.06.012. PMID 15450834.
↑ Frey, CF; Smith GJ (1987). "Description and rationale of a new operation for chronic pancreatitis.". Pancreas 2 (6): 701–7. doi:10.1097/00006676-198711000-00014. PMID 3438308.

Additional reading

Bapat RD, Satish R R, Kantharia CV. Choice Of Surgical Procedures for Chronic Pancreatitis. Bombay Hospital Journal. January 2001. Available at: 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.

Surgical procedures involving the digestive system (ICD-9-CM V3 42–54, ICD-10-PCS 0D)

Digestive tract

Upper GI tract

SGs / Esophagus	Esophagectomy Heller myotomy Sialography Impedance–pH monitoring Esophageal pH monitoring Esophageal motility study

Stomach	Bariatric surgery Adjustable gastric band Gastric bypass surgery Sleeve gastrectomy Vertical banded gastroplasty surgery Collis gastroplasty Gastrectomy Billroth I Billroth II Roux-en-Y Gastroenterostomy Gastropexy Gastrostomy Percutaneous endoscopic gastrostomy Hill repair Nissen fundoplication Pyloromyotomy

Medical imaging	Endoscopy: Esophagogastroduodenoscopy Barium swallow Upper gastrointestinal series

Lower GI tract

Small bowel	Bariatric surgery Duodenal switch Jejunoileal bypass Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery

Large bowel	Appendicectomy Colectomy Colonic polypectomy Colostomy Hartmann's operation

Rectum	Abdominoperineal resection / Miles operation Lower anterior resection Total mesorectal excision

Anal canal	Anal sphincterotomy Anorectal manometry Lateral internal sphincterotomy Rubber band ligation Transanal hemorrhoidal dearterialization

Medical imaging	Endoscopy: Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy

Stool tests	Fecal fat test Fecal pH test Stool guaiac test

Accessory

Liver	Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure

Gallbladder, bile duct	Cholecystectomy Cholecystostomy ERCP Hepatoportoenterostomy Medical imaging: Cholangiography IV MRCP PTC Cholecystography Cholescintigraphy

Pancreas	Frey's procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure

Abdominopelvic

Peritoneum	Diagnostic peritoneal lavage Intraperitoneal injection Laparoscopy Omentopexy Paracentesis Peritoneal dialysis

Hernia	Hernia repair: Inguinal hernia surgery Femoral hernia repair

Other

CPRs

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