A Case of Chronic Pancreatitis with Pancreatico-bronchial Fistula Successfully Treated with Frey's Operation

Masakazu Fujii, Tadahiko Enoki, Chizuru Nakayashiki, Toshihiro Inokuchi, Tetsuro Kobayashi, Shinji Noshima and Kensuke Esato

First Department of Surgery, Yamaguchi University School of Medicene

A 40-year-old man suffering from back pain and dyspnea was successfully treated for chronic alcoholic pancreatitis but continued to have back pain and a dry cough. He was diagnosed with a pancreatic pseudocyst, a fistulous tract reaching into the mediastinum, and pancreatolithiasis. A 9×6 mm pancreatolithiasis was observed in the pancreas head and a cyst projecting into the main pancreas duct by endoscopic retrograde cholangiopancreatography. After a median skin incision, the greater omentum was dissected transversely and the pancreas was exposed. After ultrasonographic confirmation of pancreatolithiasis and the ductal cyst, the stone was cored out of the pancreas head and a side-to-side longitudinal pancreaticojejunostomy was conducted. The patient was discharged on postoperative day 31 and the postorerative course was uneventful. The pseudocyst and fistulous tract disappeared. The man also had a normal blood glucose level of HbA_1c 5.7%.

Key words
chronic pancreatitis, Frey's procedure, pancreatico-bronchial fistula

Reprint requests
Masakazu Fujii First Department of Surgery, Yamaguchi University School of Medicene 1-1-1 Minami-Kogushi, Ube, 755-8505 JAPAN

Accepted
February 28, 2001

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