Frey procedure for surgical management of chronic pancreatitis in children.
BACKGROUND
The authors adopted the Frey procedure for the surgical management of chronic pancreatitis after one of their patients had recurrent disease in the head of the gland after a longitudinal pancreaticojejunostomy (LPJ or modified Puestow procedure). This is the first description of its use in children.


METHODS
A retrospective chart review was performed of all children undergoing a drainage or resection procedure for chronic pancreatitis from 1995 to 2002.


RESULTS
Eleven children (6 boys, 5 girls, ages 8 to 18 years) underwent either the LPJ (3) or Frey (8) procedure. Etiologies included: idiopathic (5), familial (2), congenital anomaly of the major papilla (1), pancreatic head mass (1), short bowel syndrome (1), and pancreatic divisum (1). Before surgical therapy, patients had been symptomatic 2.3 years (range, 1 month to 6 years) and had been hospitalized for pancreatitis 4 times (range, 1 to 10). Four patients did not respond to endoscopic stenting, and 5 had a pancreatic pseudocyst. Patients were followed up in clinic an average of 2.5 years, with total time elapsed since surgery averaging 4.6 years. Eight of 11 patients experienced excellent or good results subsequent to surgical intervention.


CONCLUSIONS
The Frey procedure is effective for children who have not responded to conservative management of chronic pancreatitis and may prevent recurrent disease in the head of the gland.
Rollins
Michael D
MD
Division of Pediatric Surgery, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.
Meyers
Rebecka L
RL
D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D010179:Pancreas / Q000002:abnormalities / Q000601:surgery; D010183:Pancreatic Ducts / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000601:surgery; D010193:Pancreaticojejunostomy / Q000379:methods* / Q000706:statistics & numerical data; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D016879:Salvage Therapy; D012778:Short Bowel Syndrome / Q000150:complications; D013396:Suction; D016896:Treatment Outcome
D015282:Octreotide