Therapeutic angioembolization of bleeding pancreaticoduodenal artery pseudoaneurysm following laparoscopy assisted Frey's procedure

Abstract

Introduction: Minimal access surgery has revolutionized surgery and is considered the gold standard of management for most surgical pathologies of the abdomen. We present a case which to our best knowledge is the first ever report of the nonsurgical management of a pancreaticoduodenal artery (PDA) pseudo aneurysm following laparoscopy assisted Frey's procedure (LAFP). Case Report: A 38yearold male patient was transferred to our hospital due to persistent gastrointestinal bleeding following LAFP. He underwent LAFP for chronic calcific pancreatitis (CCP) two weeks prior to his transfer. Computed tomography angiogram showed the source of bleeding to be a branch of superior pancreaticoduodenal artery (SPDA). The patient was taken to interventional radiology where successful superselective microcoil embolization was performed. We present this rare case of pancreaticoduodenal pseudoaneurysm along with a review of medical

Laparoscopic Frey’s Procedure for Chronic Pancreatitis in a Japanese Patient

“…Tan et al described the successful treatment of 7 out of 9 patients who underwent laparoscopic Frey's procedure for chronic pancreatitis, showing the comparable outcome of laparoscopic Frey's procedure to that of open surgery [8]. Despite positive outcomes, there remain few publications of laparoscopic Frey's procedure [7][8][9][10]. Kilburn et al described the importance of appropriate patient selection, remarking that some patients are poor candidates for laparoscopic Frey's procedure, with technical difficulties commonly manifested in patients with a history of extensive abdominal surgery or obesity [10].…”

“…Recently, laparoscopic pancreatic surgery has become increasingly preferred because of its noninvasiveness [ 4 – 6 ]. However, limited reports of Frey’s procedure performed laparoscopically exist [ 7 – 9 ]. To our knowledge, we present the first case of chronic pancreatitis successfully treated by laparoscopic Frey’s procedure in a Japanese patient.…”