Frey procedure for chronic pancreatitis: A narrative review

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Chronic pancreatitis (CP) is a progressive inflammatory condition causing severe abdominal pain and impaired pancreatic function.
• Surgical intervention is often necessary for intractable pain in up to 50% of CP patients.
• Surgical approach depends on pancreatic duct diameter and head mass characteristics.

Purpose of the Study:

• To evaluate the Frey procedure (FP) as a surgical option for chronic pancreatitis.
• To compare the outcomes of FP with pancreaticoduodenectomy (PD) and the Beger procedure.
• To assess FP's efficacy in pain management and its technical feasibility.

Main Methods:

• Comparative analysis of surgical outcomes for CP patients undergoing FP, PD, and Beger procedures.
• Evaluation of key metrics including operation time, blood loss, morbidity, and hospital stay.
• Assessment of long-term pain control and pancreatic function.

Main Results:

• The Frey procedure shows shorter operation times and lower morbidity compared to the Beger procedure.
• FP demonstrates favorable outcomes over pancreaticoduodenectomy regarding operation time, blood loss, morbidity, and length of stay.
• Long-term pain relief and preservation of exocrine/endocrine function are comparable across FP, PD, and Beger procedures.
• FP is technically simpler than PD and the Beger procedure.

Conclusions:

• The Frey procedure is a safe and effective surgical option for chronic pancreatitis with an enlarged pancreatic head, especially when neoplasia is absent.
• FP offers advantages in terms of operative efficiency and patient recovery compared to other major pancreatic resections.
• FP provides comparable long-term functional outcomes to other procedures while being technically less demanding.