Robotic versus open Frey's procedure for chronic pancreatitis: a single center's experience of 40 cases over a 7-year...

Chronic pancreatitis (CP) is a progressive inflammatory disease characterized by structural damage and chronic pancreatic fibrosis. Frey's procedure combined both resection and drainage, is a safe and effective procedure for chronic pancreatitis.

This study aims to compare the effect of robotic and open Frey's procedure in our single center. A retrospective study of patients who underwent a Frey's procedure (robotic and open) due to CP between January 2016 to December 2022 in a hospital in Xi'an Jiaotong University was made.

In our study, 40 patients met the inclusion criteria, 72.5% of patients were male. The etiology in most cases (47.5%) was idiopathic, and 32.5% of patients were alcoholic. 22.5% patients received extracorporeal shock wave lithotripsy (ESWL) before surgery. 21/40 patients underwent robot assisted Frey's procedure. The duration of surgery was longer in robotic group (315 min vs. 238 min, p = 0.004). The median length of in-hospital stay and postoperative hospital stay were shorter in the robotic group. There was no significant difference in the postoperative complications and short-term outcomes of pancreatic exocrine and endocrine dysfunction between the two groups. The rate of pain relief was 100%. Although no significant difference was observed in the operation time and postoperative complications between the patient who got pre-operative ESWL or not, patients who received ESWL before surgery were most likely to have easily stones removed.

Robotic Frey's procedure is safe and feasible for CP patients. Preoperative ESWL treatment may be helpful for intraoperative pancreatic duct stone removal.