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World J Gastrointest Surg. Jul 27, 2014; 6(7): 129-135
Published online Jul 27, 2014. doi: 10.4240/wjgs.v6.i7.129
Chronic pancreatitis: A surgical disease? Role of the Frey procedure
Alexandra Roch, Jérome Teyssedou, Didier Mutter, Jacques Marescaux, Patrick Pessaux
Alexandra Roch, Jérome Teyssedou, Didier Mutter, Jacques Marescaux, Patrick Pessaux, Digestive and Endocrine Surgery, Nouvel Hôpital Civil, University of Strasbourg, 67000 Strabourg, France
Alexandra Roch, Jérome Teyssedou, Didier Mutter, Jacques Marescaux, Patrick Pessaux, Institut de recherche en cancérologie de l’appareil digestif (IRCAD), 67000 Strasbourg, France
Alexandra Roch, Jérome Teyssedou, Didier Mutter, Jacques Marescaux, Patrick Pessaux, IHU-Strasbourg, Minimally-Invasive Image-Guided Surgical Institute, University of Strasbourg, 67000 Strabourg, France
Author contributions: All the authors contributed to this paper.
Correspondence to: Patrick Pessaux, MD, PhD, Professor, Head of the Hepatobiliary and Pancreatic Surgical Unit, Digestive and Endocrine Surgery, Nouvel Hôpital Civil, University of Strasbourg, 1 place de l’hopital, 67000 Strasbourg, France. patrick.pessaux@chru-strasbourg.fr
Telephone: +33-3-69551563
Received: March 21, 2014
Revised: April 26, 2014
Accepted: July 12, 2014
Published online: July 27, 2014
Processing time: 126 Days and 13.8 Hours
Abstract

Although medical treatment and endoscopic interventions are primarily offered to patients with chronic pancreatitis, approximately 40% to 75% will ultimately require surgery during the course of their disease. Although pancreaticoduodenectomy has been considered the standard surgical procedure because of its favorable results on pain control, its high postoperative complication and pancreatic exocrine or/and endocrine dysfunction rates have led to a growing enthusiasm for duodenal preserving pancreatic head resection. The aim of this review is to better understand the rationale underlying of the Frey procedure in chronic pancreatitis and to analyze its outcome. Because of its hybrid nature, combining both resection and drainage, the Frey procedure has been conceptualized based on the pathophysiology of chronic pancreatitis. The short and long-term outcome, especially pain relief and quality of life, are better after the Frey procedure than after any other surgical procedure performed for chronic pancreatitis.

Keywords: Chronic pancreatitis; Frey procedure; Surgery; Complication; Outcome

Core tip: The management and the treatment of chronic pancreatitis are challenging. Many surgical procedures were described with 2 different types of concepts: resection vs drainage. The Frey procedure is an association of these 2 concepts. This manuscript contains the most recent data about the technique, the short and long-term outcomes of this technique. In addition, there is a review of the literature of series comparing this technique with the other surgical procedures.