Laparoscopic versus open Frey procedure: Comparative analysis of short and long-term outcomes

Frey procedure is one of the most common surgical treatment options for chronic pancreatitis. The data on safety and effectiveness of laparoscopic approach in Frey procedure are very limited. In the present study a comparative analysis of the short- and long-term outcomes of laparoscopic versus open Frey procedure was demonstrated.

Seventy-nine consecutive patients with chronic pancreatitis submitted to either open (n - 29) (OFP) or laparoscopic (n - 50) (LFP) Frey procedure between September 2012 and January 2020, were evaluated.

The laparoscopic approach was performed fully on 45 (90%) patients. Conversion was needed in 4 (8%) cases, 1 patient (2%) was converted to laparoscopic Beger procedure. The median operative time was 420 (290-685) min after LFP and 310 (179-515) min after OFP. The blood loss was 100 (30-700) ml and 225 (50-1200) ml, respectively. The pain score on POD 3 was 2 (1-4) in LFP group and 4 (2-8) after OFP. The length of hospital stay was 6 (3-25) days after LFP and 9.5 (5-42) days after OFP. In the LFP and OFP groups the postoperative complications occurred in 11 (24.4%) and 8 (28.5%) patients, respectively. The follow-up period lasted for 36 (6-60) months after LFP and 60 (6-60) months after OFP. Poor pain control with the need for non-opioid analgesics intake was observed in 4 patients in the LFP group and in 3 patients after OFP.

Laparoscopic Frey procedure is an efficient and safe intervention, which provides all the advantages of the minimally invasive approach.