Dilated pancreatic duct with multiple pancreatic calcifications and stones
10 cm fluid collection in the lesser sac
Laboratory Findings:
Low hemoglobin
HbA1c: 11.2%
Parathyroid hormone (PTH): Normal
Surgical Procedure
Approach: Open
Procedure Performed:
Frey’s Procedure (Pancreatic head resection with lateral pancreatico-jejunostomy)
Drainage of the lesser sac collection
Intraoperative Findings:
Multiple calcifications in the pancreas (confirmed on intraoperative X-ray)
No intraductal stones
Atrophic pancreatic head
Pseudocyst arising from the pancreatic head
Surgical Details:
Pancreatic head resection performed, leaving a thin rim of pancreatic tissue
Roux-en-Y loop of jejunum anastomosed to the resected pancreatic head and longitudinally to the main duct
Pseudocyst decompressed via communication with the main duct, resolving with drainage
Postoperative Course
Recovery: Uneventful
Hospital Stay: Discharged on postoperative day 6
Outcome:
No postoperative abdominal pain
Improved glycemic control
Take-Home Message
Pancreatic head resection with drainage (Frey’s Procedure) offers an effective and feasible solution for chronic symptomatic calcific pancreatitis, providing long-term pain relief and improved metabolic control.
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