✦ PANCREAS · COMBINED PROCEDURE

Frey Procedure

Q: When is the Frey procedure chosen over the Puestow?

Frey is chosen when chronic pancreatitis has a prominent inflammatory head mass, the dominant pain source.

Q: What is the difference between Frey and Whipple's procedure?

The Frey preserves the duodenum, bile duct, and most of the pancreatic head, only coring the inflammatory tissue.

Q: Will I develop diabetes after the Frey procedure?

The Frey preserves significantly more pancreatic tissue than Whipple's, reducing new-onset diabetes risk.

Combined local pancreatic head resection with lateral pancreaticojejunostomy — for chronic pancreatitis with head mass.

180–300 Min TREATMENT DURATION

7–10 Days CARE SETTING

Open APPROACH

6–8 Weeks RECOVERY TIMELINE

What is Frey Procedure?

The Frey procedure combines limited local resection of the inflammatory pancreatic head with a lateral pancreaticojejunostomy. Unlike the Whipple procedure, the duodenum and bile duct are preserved. The dual approach addresses both the head pain generator and the ductal hypertension. Dr. Tagore Mohan Grandhi performs the Frey procedure for chronic pancreatitis with a prominent inflammatory head mass causing both ductal obstruction and direct compression of adjacent structures. Over 85% achieve durable pain relief.

Suitable for patients with chronic pancreatitis and a prominent inflammatory head mass where the head is the dominant pain generator, where drainage alone (Puestow) provides insufficient relief.

How the Procedure Works

Pre-operative Assessment

CT and MRCP assess head mass size, ductal anatomy, and vascular involvement. Malignancy excluded by EUS-FNA if diagnosis is uncertain.

Pancreatic Head Coring

Inflammatory head tissue cored out under direct vision preserving the duodenum, bile duct, and posterior capsule.

Longitudinal Ductotomy

Main duct opened longitudinally from head to tail addressing the entire ductal system.

Pancreaticojejunostomy

Roux-en-Y jejunal loop anastomosed to the opened duct and cored head, providing comprehensive dual drainage.

Recovery

Oral fluids day two. Discharged in 6–8 days. Pancreatic enzyme replacement continued. Pain assessed at 6-week review.

Outcomes

180–300 MinTREATMENT DURATION

7–10 DaysCARE SETTING

OpenAPPROACH

6–8 WeeksRECOVERY TIMELINE

Who Needs This Treatment?

→Preserves duodenum and bile duct — maintains normal digestive anatomy
→Dual drainage and head decompression addresses pain from two sources
→85%+ durable long-term pain relief
→Lower operative risk than Whipple's for benign chronic pancreatitis

The Frey procedure is our preferred operation when the pancreatic head is the dominant pain generator in chronic pancreatitis. Preserving the duodenum while draining the entire duct gives patients excellent results with fewer complications than Whipple's.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

When is the Frey procedure chosen over the Puestow?+

What is the difference between Frey and Whipple's procedure?+

Will I develop diabetes after the Frey procedure?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tagore Grandhi and get a personalised treatment plan.

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