Complications after Freyʹs procedure for chronic pancreatitis

Background Freyʹs operation is indicated on patients with chronic pancreatitis who have “head dominant” disease and involves resection of the head of pancreas and lateral pancreaticojejunostomy (LRLPJ). There is little information about the postoperative complications after this procedure and the factors likely to be responsible for them. This paper addresses this aspect of LRLPJ. Methods A retrospective review was made of records of 41 patients undergoing LRLPJ for chronic pancreatitis between January 1990 to June 2003. Results Sixteen (39%) patients had 19 complications in the early postoperative period; septic complications were the commonest. One patient died. Regression analysis showed preoperative endoscopic pancreatic stenting to be the factor responsible for majority of these complications (P = 0.0041). Patients with a history of pancreatic stenting had a prolonged hospital stay (P = 0.022). Conclusions Postoperative complications after LRLPJ are usually septic in nature and are likely to occur more often in patients in whom endoscopic pancreatic stenting has been performed before surgical intervention.