Pancreas Treatments

Pancreatic Duct Drainage

Chronic pancreatitis often results in narrowing or blockage of the pancreatic ducts, as well as severe stomach pain. In these cases, a surgical procedure to open and drain the blocked pancreatic duct is generally recommended. At Emory, our surgeons use one of a number of techniques depending on each patient’s presentation.

Puestow Procedure

The most common approach to drain blocked pancreatic ducts is the Puestow procedure, also known as a pancreaticojejunostomy. During this operation, the surgeon opens up the entire length of the pancreas and main pancreatic duct and attaches a length of small intestine called the jejunum lengthwise along the incision to allow for better drainage of pancreatic juices. This procedure keeps the pancreas and the duodenum (upper portion of the small intestine) intact. It can be performed using an open surgical or minimally invasive approach.

Frey Procedure

The Frey procedure combines the Puestow procedure with the hollowing out and clearing of the diseased portions of the duct within the head of the pancreas. The Frey procedure is generally more appropriate for cases in which the bulk of the blockage is in the head of the pancreas.

Beger Procedure

During the Beger procedure, most of the head of the pancreas is removed, while leaving a channel to the duodenum and the duodenum itself intact. As with the Puestow and Frey procedures, a portion of the jejunum is brought up and attached to the pancreas to improve drainage of pancreatic juices. But instead stitching the jejunum alongside the length of the pancreas, it is instead attached to the remaining body of the pancreas and pancreatic duct where the head was resected.

Pancreas Conditions