🚨 24/7 Acute Pancreatitis & Surgical Helpline: +91 63530 90080 | +91 98322 22233 (Gujarat Gastro & Vascular Hospital, Adajan, Surat)
Dr. Naresh Gabani Pancreas, Liver & GI Robotic Surgeon
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Pancreatic Care

Acute & Chronic Pancreatitis Surgical Care

Evidence-based step-up necrosectomy for severe acute pancreatitis, and Frey's procedure for chronic stone pain relief in Surat.

Pancreatitis requires an individualized strategy. While mild attacks resolve with conservative hospital care, severe acute necrotizing disease and stone-forming chronic pancreatitis demand specialized surgical gastroenterology expertise.

Pancreas Anatomy and Biliary Tree

Acute Pancreatitis: The Step-Up Protocol

In severe acute pancreatitis, areas of the gland can lose blood supply and become necrotic. If bacteria enter this necrotic tissue (infected pancreatic necrosis), the risk of sepsis rises significantly.

Rather than premature open surgery, Dr. Naresh Gabani practices the internationally validated Step-Up Approach:

  • 1. Aggressive Fluid & Organ Support: Early resuscitation in the High-Dependency Surgical ICU to protect renal and lung function.
  • 2. Image-Guided Percutaneous Drainage (PCD): Placing fine pigtail catheters to drain infected fluid under CT or ultrasound guidance. Many patients stabilize with this alone.
  • 3. Minimally Invasive Retroperitoneal Necrosectomy (VARD): If symptoms persist, dead necrotic tissue is extracted through small flank keyhole incisions without violating the peritoneal cavity.
  • 4. Index Cholecystectomy: In gallstone-induced pancreatitis, laparoscopic removal of the gallbladder is performed prior to discharge to prevent recurrent attacks.

Chronic Pancreatitis: Frey's Procedure for Durable Pain Relief

Chronic pancreatitis causes irreversible architectural fibrosis, ductal strictures, and intraductal stone calcifications. Patients endure debilitating pain and progressive weight loss.

The Frey Procedure (Local Pancreatic Head Resection & Longitudinal Pancreaticojejunostomy) is the surgical gold standard. It coring out the diseased head of the gland (the "pacemaker of pain") and opens the main pancreatic duct from head to tail, sewing it to the jejunum.

Why Frey's Operation Excels:

  • Over 85–90% Pain Relief: Decompresses obstructed duct pressure and removes dense inflammatory tissue.
  • Preserves Endocrine Function: Minimizes the risk of post-surgical diabetes compared to total pancreatectomy.
  • Preserves Digestive Anatomy: Avoids removing the duodenum or bile duct, maintaining natural food pathways.