Surgery for chronic pancreatitis has been shown to be the most effective treatment, but not for all patients. The various options have been well studied and the Frey procedure is the best overall option for suitable patients. It combines decompression with a limited resection. The advantage is the preservation of pancreatic function.
Patients should have stopped drinking and have a dilated main pancreatic duct. The patients that benefit the most are those who are not dependent on narcotics and those who have a marked spike of pain after meals.
The Frey procedure involves opening the pancreatic duct along its length and coring the head of the pancreas out to allow for satisfactory drainage. Small intestine is brought up to lie alongside the pancreas and a long join is made (pancreato-jejunostomy).
There are a number of specific complications that can occur including bleeding and a pancreatic leak, but these occur in less than 20% of cases. The patients are usually in hospital for 7 days and need a month to recover.