Distal Pancreatectomy (Frey Procedure)
The term distal pancreatectomy describes resection of variable amounts of the body and tail of the pancreas. Partial pancreatic resection is recommended for patients with diffuse (moderate to severe) parenchyma disease without ductal dilation, especially in the tail and body. Local resection of major pancreatic sites of involvement may be sufficient for those patients with regional disease, whereas a 95% distal resection is recommended for patients with diffuse disease. Ninety-five percent distal pancreatectomy entails removal of the spleen and almost all of the pancreas, except for a thin rim of tissue within the "C" loop of the duodenum. Splenic preservation is attempted, but often fails because dissection of splenic vessels from the chronically inflamed and scarred pancreas is extremely difficult. This procedure provides pain relief for 75–80% of patients and has a mortality rate less than 5%.