Robotic versus open Frey’s procedure for chronic pancreatitis: a single center’s experience of 40 cases over a 7-year period

BACKGROUND: Chronic pancreatitis (CP) is a progressive inflammatory disease characterized by structural damage and chronic pancreatic fibrosis. Frey's procedure combined both resection and drainage, is a safe and effective procedure for chronic pancreatitis. METHODS: This study aims to compare the effect of robotic and open Frey's procedure in our single center. A retrospective study of patients who underwent a Frey's procedure (robotic and open) due to CP between January 2016 to December 2022 in a hospital in Xi'an Jiaotong University was made. RESULTS: In our study, 40 patients met the inclusion criteria, 72.5% of patients were male. The etiology in most cases (47.5%) was idiopathic, and 32.5% of patients were alcoholic. 22.5% patients received extracorporeal shock wave lithotripsy (ESWL) before surgery. 21/40 patients underwent robot assisted Frey's procedure. The duration of surgery was longer in robotic group (315 min vs. 238 min, p = 0.004). The median length of in-hospital stay and postoperative hospital stay were shorter in the robotic group. There was no significant difference in the postoperative complications and short-term outcomes of pancreatic exocrine and endocrine dysfunction between the two groups. The rate of pain relief was 100%. Although no significant difference was observed in the operation time and postoperative complications between the patient who got pre-operative ESWL or not, patients who received ESWL before surgery were most likely to have easily stones removed. CONCLUSIONS: Robotic Frey's procedure is safe and feasible for CP patients. Preoperative ESWL treatment may be helpful for intraoperative pancreatic duct stone removal.