Frey Procedure Using Double Roux-en-Y Technique for Chronic Pancreatitis Due to Postoperative Congenital Biliary Dilatation

Abstract

We report the case of a 20-year-old female patient who underwent the Frey procedure using the double Roux-en-Y technique for chronic pancreatitis and postoperative complications after hepaticojejunostomy for congenital biliary dilation (CBD). She underwent laparoscopic cholecystectomy owing to the idiopathic perforation of the gallbladder at 4 years of age and hepaticojejunostomy for CBD at 7 years of age. However, she previously experienced repeated episodes of acute pancreatitis despite no clear evidence of pancreas divisum on ERP or MRCP. Endoscopic sphincterotomy and stent insertion did not improve her symptoms. Enhanced CT revealed chronic pancreatitis with stone formation and the dilatation of the distal pancreatic duct at 19 years of age. The pancreatic calculus was removed and the Frey procedure using the double Roux-en-Y technique was performed to treat her chronic pancreatitis. Her abdominal symptoms improved after surgery. Surgery should be selected for patients with chronic pancreatitis with pancreatic calculus and who respond poorly to conservative management. The Frey procedure using the double Roux-en-Y technique is a safe and effective intervention for chronic pancreatitis in patients with postoperative CBD.