A Case of Frey's Operation for Obstructive Jaundice Caused by the Incarceration of Pancreatic Stones in the Ampulla of Papilla of Vater

A 64-year-old man was admitted to our hospital because of upper abdominal pain. Abdominal computed tomography revealed chronic pancreatitis with pancreatic stones and choledocholithiasis. The endoscopic procedure was unsuccessful. We performed surgical transduodenal papillotomy and removal of an incarcerated stone of 15 mm in diameter. The stone was a pancreatic stone and there were many other pancreatic stones in the dilated duct and parenchyma of the head and untinate process of the pancreas. We therefore performed coring out the head of the pancreas with side to side pancreaticojejunostomy (Frey's procedure). The incarceration of pancreatic stones in biliary system is very rare, but we should consider the possibility of this situation in the diagnosis of obstructive jaundice in patients with pancreatolithiasis.