Abstract
Chronic pancreatitis is a multifactorial disease process associated with high morbidity. The workup and perioperative management of this disease can be challenging given its complex pathophysiology. Multidisciplinary lifestyle and medical management strategies should be utilized when feasible prior to invasive interventions, either endoscopic or surgical. Using a case presentation format, key perioperative assessment and management strategies for chronic pancreatitis are highlighted, in addition to technical pearls to guide intraoperative management using the Frey procedure (duodenal-preserving partial pancreatic head resection with lateral pancreaticojejunostomy). Patients with pancreatic ductal dilation greater than or equal to 7 mm, or dilated with multiple ductal strictures causing disabling or severe pain, should undergo a Frey procedure. Asymptomatic patients or those with an inflammatory mass/calcification in the pancreatic head associated with ductal dilation are also candidates.
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