{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:15:30Z","timestamp":1789992930186,"version":"4.0.1"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Today"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Although the Frey procedure effectively treats chronic pancreatitis, late relapse can occur in the pancreatic tail. This paper details the essential steps of combining the Frey procedure with distal pancreatectomy (Frey\u2009+\u2009DP) to address this issue. The key surgical steps include distal pancreatectomy, longitudinal opening of the main pancreatic duct, pancreatic head coring, and longitudinal pancreaticojejunostomy. Comparing the outcomes of nine Frey\u2009+\u2009DP and 13 Frey-alone patients (2016\u20132024), Frey\u2009+\u2009DP had significantly longer operative times and higher estimated blood loss. However, the postoperative hospital stay, mortality, 1-year pain recurrence, and new-onset diabetes were comparable between the two groups. Although more invasive, Frey\u2009+\u2009DP definitively treats concurrent severe tail disease, mitigating the risk of late relapse and requiring difficult reoperations. Frey\u2009+\u2009DP is a safe and effective approach for patients with chronic pancreatitis with inflammatory lesions in both the pancreatic head and tail.<\/jats:p>","DOI":"10.1007\/s00595-026-03410-0","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:48:38Z","timestamp":1789991318000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frey procedure with distal pancreatectomy: How to do it"],"prefix":"10.1007","author":[{"given":"Masaharu","family":"Ishida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Umino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Shimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koetsu","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Iseki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Douchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimpei","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamichi","family":"Mizuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kamei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Egawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiaki","family":"Unno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"3410_CR1","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/00006676-198711000-00014","volume":"2","author":"CF Frey","year":"1987","unstructured":"Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas. 1987;2:701\u20137.","journal-title":"Pancreas"},{"key":"3410_CR2","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1097\/00000658-199812000-00008","volume":"228","author":"JR Izbicki","year":"1998","unstructured":"Izbicki JR, Bloechle C, Broering DC, Knoefel WT, Kuechler T, Broelsch CE. Extended drainage versus resection in surgery for chronic pancreatitis: a prospective randomized trial comparing the longitudinal pancreaticojejunostomy combined with local pancreatic head excision with the pylorus-preserving pancreatoduodenectomy. Ann Surg. 1998;228:771\u20139.","journal-title":"Ann Surg"},{"key":"3410_CR3","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1097\/00000658-199504000-00004","volume":"221","author":"JR Izbicki","year":"1995","unstructured":"Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial. Ann Surg. 1995;221:350\u20138.","journal-title":"Ann Surg"},{"key":"3410_CR4","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1007\/s00534-009-0185-4","volume":"17","author":"S Egawa","year":"2010","unstructured":"Egawa S, Motoi F, Sakata N, Kitamura Y, Nakagawa K, Ohtsuka H, et al. Assessment of Frey procedures: Japanese experience. J Hepatobiliary Pancreat Sci. 2010;17:745\u201351.","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"3410_CR5","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00595-018-1720-1","volume":"49","author":"H Sato","year":"2019","unstructured":"Sato H, Ishida M, Motoi F, Sakata N, Aoki T, Suzuki H, et al. Combination of longitudinal pancreaticojejunostomy with coring-out of the pancreatic head (Frey procedure) and distal pancreatectomy for chronic pancreatitis. Surg Today. 2019;49:137\u201342.","journal-title":"Surg Today"},{"key":"3410_CR6","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.surg.2016.11.014","volume":"161","author":"C Bassi","year":"2017","unstructured":"Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017;161:584\u201391.","journal-title":"Surgery"},{"key":"3410_CR7","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1097\/00000658-196012000-00015","volume":"152","author":"PF Partington","year":"1960","unstructured":"Partington PF, Rochelle RE. Modified Puestow procedure for retrograde drainage of the pancreatic duct. Ann Surg. 1960;152:1037\u201343.","journal-title":"Ann Surg"},{"key":"3410_CR8","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1007\/s00534-009-0181-8","volume":"17","author":"S Isaji","year":"2010","unstructured":"Isaji S. Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence. J Hepatobiliary Pancreat Sci. 2010;17:763\u20139.","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"3410_CR9","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.hpb.2015.10.003","volume":"18","author":"ZAR Jawad","year":"2016","unstructured":"Jawad ZAR, Tsim N, Pai M, Bansi D, Westaby D, Vlavianos P, et al. Short and long-term post-operative outcomes of duodenum preserving pancreatic head resection for chronic pancreatitis affecting the head of pancreas: a systematic review and meta-analysis. 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