Document Detail


Late failure of Frey procedure due to gastro-jejunal fistula formation.
MedLine Citation:
PMID:  19581754     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Local resection of the pancreatic head with longitudinal pancreaticojejunostomy (or Frey procedure) generally results in excellent pain relief in chronic pancreatitis. We report a patient with chronic pancreatitis who experienced pain recurrence after an uneventful longitudinal pancreaticojejunostomy. CASE REPORT: This is a single case study of a 58-year-old female with chronic pancreatitis undergoing longitudinal pancreaticojejunostomy for pain relief. Fifteen months after the surgery, the patient experienced pain recurrence. Radiologic evaluation followed by surgical exploration revealed a gastroenteric fistula to the Roux-limb, with obliteration of the anastomosis. After repair of the fistula and re-excavation of the pancreatic head, a two-layer longitudinal pancreaticojejunostomy was reconstructed from the same Roux-limb. An omental flap was interposed between the Roux limb and the repaired stomach. At 6-month follow-up, the patient was pain free and asymptomatic. CONCLUSION: Late failure of the Frey procedure due to a gastroenteric fistula to the Roux-limb of jejunum has not been previously reported. This finding may explain one of the causes of longitudinal pancreaticojejunostomy late failure.
Authors:
Atoosa Rabiee; Kevin Moreman; Parviz Nikoomanesh; Dana K Andersen
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-07-06
Journal Detail:
Title:  JOP : Journal of the pancreas     Volume:  10     ISSN:  1590-8577     ISO Abbreviation:  JOP     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-07     Completed Date:  2009-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101091810     Medline TA:  JOP     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  445-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. arabiee1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Intestinal Fistula / diagnosis*,  etiology,  surgery
Middle Aged
Pain / etiology
Pancreaticojejunostomy / adverse effects,  methods*
Pancreatitis, Chronic / surgery
Postoperative Complications / diagnosis*,  etiology,  surgery
Recurrence
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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