[The Frey Procedure in the Surgical Treatment of Chronic Pancreatitis]

There are currently controversies about the best strategy for pain relief in chronic pancreatitis refractory to analgesics.

The objective of this work was to evaluate the results of Frey's procedure in the surgical treatment of pain.

Between June 1995 and June 2019, patients who underwent Frey's procedure were included. The morphological characteristics of the pancreas were evaluated by tomography and/or magnetic resonance imaging, the endocrine and exocrine function before surgery, as well as the immediate and distant results (operative morbidity and mortality; and pain relief and pancreatic insufficiency) results. A retrospective analysis of a prospective database was made.

59 Frey procedures were performed (8 women and 51 men). The average age was 38.7 years (32-57). All patients had a head mass and a Wirsung duct greater than 6mm on imaging. They were all operated within three years of starting medical treatment for pain. 5 received opioids (for less than six months) and none were treated endoscopically. 5 patients presented complications (8.4%) and there was no mortality. The success rate of the procedure was 90.5%. Five patients developed diabetes and 8 steatorrhea.

Frey's procedure is a safe and effective surgical technique for pain management in chronic pancreatitis. The success of the treatment may be influenced by a shorter previous medical treatment and the absence of endoscopic procedures. These findings need to be confirmed by further studies.