The Frey procedure with the use of 2 types of ultrasonically activated scalpels for chronic pancreatitis: report of a case.

A surgical procedure is the only way to relieve intractable pain in patients with chronic pancreatitis and an inflammatory mass in the pancreas head. Although the Frey procedure is safer and more effective for pain relief than is standard pancreaticodudenectomy, it is often associated with such complications as pancreatic fistula and postoperative hemorrhage. A 64-year-old man was admitted to our hospital because of increasingly frequent episodes of epigastralgia. This patient had continued to abuse alcohol until recently and was regularly using painkillers to relieve severe pain due to chronic pancreatitis. The patient underwent the Frey procedure with the use of 2 types of ultrasonically activated scalpel. There were no surgery-related complications. The patient was discharged 18 days after the operation. Neither recurrence of pain nor locoregional complications have been observed for 2 years after the procedure. Herein we report the use of the Frey procedure to treat an enlarged mass of the pancreatic head and discuss the efficacy of the ultrasonically activated scalpel for excavation of the pancreatic head and long dichotomy of the pancreatic duct.