Subscribe to RSS
DOI: 10.1055/s-0029-1202249
© Georg Thieme Verlag KG Stuttgart · New York
Frey Procedure for Chronic Pancreatitis in a Child with Duodenal Atresia and Complex Pancreaticobiliary Disorders
Publication History
received August 16, 2008
accepted after revision December 10, 2008
Publication Date:
03 April 2009 (online)

Abstract
A boy aged 2 years and 7 months who had undergone duodeno-duodenostomy for duodenal atresia and annular pancreas in the neonatal period presented with recurrent pancreatitis. ERCP showed an incomplete pancreas divisum associated with pancreaticobiliary maljunction. At 3 years and 8 months of age, we performed a Frey procedure in combination with total excision of the extrahepatic bile duct. The main pancreatic duct was opened in the body and the head was cored out anteriorly. The pancreaticobiliary system was reconstructed with a Roux-en-Y anastomosis. The patient has been free from symptoms with excellent weight gain in the follow-up period of 20 months. The Frey procedure can be a safe and effective operation in children with chronic pancreatitis caused by complex pancreatobiliary disorders associated with duodenal atresia.
Key words
chronic pancreatitis - pancreas divisum - pancreaticobiliary maljunction - Frey procedure - children
References
- 1
Chiu B, Lopoo J, Superina RA.
Longitudinal pancreaticojejunostomy and selective biliary diversion for chronic pancreatitis
in children.
J Pediatr Surg.
2006;
41
946-949
Reference Ris Wihthout Link
- 2
Frey CF.
The surgical management of chronic pancreatitis: The Frey procedure.
Adv Surg.
1999;
32
41-85
Reference Ris Wihthout Link
- 3
Frey CF, Akimura K.
Local resection of the head of the pancreas combined with longitudinal pancreatojejunostomy
in the management of patients with chronic pancreatitis.
Ann Surg.
1994;
220
492-504
Reference Ris Wihthout Link
- 4
Rollins MD, Meyers RL.
Frey procedure for surgical management of chronic pancreatitis in children.
J Pediatr Surg.
2004;
39
817-820
Reference Ris Wihthout Link
- 5
Sakorafs GH, Tsiotou AG.
Proximal pancreatectomy in the surgical management of chronic pancreatitis.
J Clin Gastroenterol.
2002;
34
72-76
Reference Ris Wihthout Link
- 6
Schlosser W, Rau BM, Poch B, Beger HG.
Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits
of duodenum-preserving pancreatic head resection.
J Gastrointest Surg.
2005;
9
710-715
Reference Ris Wihthout Link
- 7
, Neblett III WW, O’Neil
Jr JA.
Surgical management of recurrent pancreatitis in children with pancreas divisum.
Ann Surg.
2000;
231
899-908
Reference Ris Wihthout Link
- 8
Yogi Y, Kosai S, Higashi S, Iwamura T, Setoguchi T.
Annular pancreas associated with pancreatolithiasis: a case report.
Hepatogastroenterology.
1999;
46
527-531
Reference Ris Wihthout Link
- 9
Zyrmoski NJ, Sandoval JA, Pitt HA, Ladd AP, Fogel EL, Mattar WE, Sandrasegaran K, Amrhein DW, Rescorla FJ, Howard TJ, Lillemoe KD, Grosfeld JL.
Annular pancreas: dramatic differences between children and adults.
J Am Coll Surg.
2008;
206
201-205
Reference Ris Wihthout Link
Correspondence
Dr. H. Okuyama
Hyogo College of Medicine
Pediatric Surgery
1-1
Mukogawa-cho
Nishinomiya
663-8501 Hyogo
Japan
Phone: 81/798/45 65 82
Fax: 81/798/45 65 81
Email: okuyama@hyo-med.ac.jp