On 25-10-2022, a case of a 34 years male was presented in the department of Surgical Gastroenterology with a history of recurrent upper abdominal pain for 3 years. On examination and investigation, he was diagnosed with chronic calcific pancreatitis for 3 years; he was on multiple analgesics. Despite medication intake, he was suffering from intractable pain.
The patient had lost around 8 kg weight in the last year and was suffering from intractable pain & persistent intrapancreatic pseudocyst, which required surgery to remove. The abdomen showed signs of atrophy of the pancreas and a dilated main pancreatic duct around 7mm in diameter.
On day two patients underwent a supra-major surgery with a combination of two procedures.
1) Drainage Of Intrapancreatic Pseudocyst +2) Frey’s Procedure.
There were multiple intraductal calculi with dilated MPD more than 1cm with disruption of MPD at the head region and formation of a pseudocyst.
His postoperative period was uneventful and Inj. OCTREOTIDE100 mcg s/c TID was given for the first three postoperative days to prevent postoperative pancreatic fistula, as there was pery pancreatic inflammation and pancreatic pseudocyst.
Combining the drainage of the intrapancreatic pseudocyst with Frey’s procedure is uncommon.
On 02-11-2022, the patient was discharged in good general condition. He was given follow-up medication and dietary advice of a high-protein and low-fat diet. Postoperative pancreatic fistula and hemorrhage should be kept in mind before adding up both procedures.
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