A patient with chronic pancreatitis has a dilated main pancreatic duct (>7 mm) with a dominant inflammatory head mass. Which surgical procedure offers both decompression and mass resection with preservation of the duodenum?
- A Frey procedure (local pancreatic head excision with lateral pancreaticojejunostomy) ✓
- B Puestow procedure (lateral pancreaticojejunostomy)
- C Beger procedure (duodenum-preserving pancreatic head resection)
- D Whipple pancreaticoduodenectomy
Correct answer: A. Frey procedure (local pancreatic head excision with lateral pancreaticojejunostomy)
Explanation
The Frey procedure combines local excavation of the pancreatic head (coring out the fibrotic mass) with a longitudinal lateral pancreaticojejunostomy — addressing both the head mass and the dilated duct in a single anastomosis. The Beger procedure removes the pancreatic head entirely but preserves the duodenum with two anastomoses. The Puestow only decompresses the duct without treating the head mass. The Frey is technically simpler than Beger with equivalent pain relief.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.