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Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis
Published on: September 5, 2025
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Laparoscopic Puestow: lateral pancreaticojejunostomy
Benjamin R Biteman1, Jeffrey N Harr2, Fred Brody2
1Department of Surgery, Medical Faculty Associates, The George Washington University Medical Center, 2150 Pennsylvania Ave NW, 6th Floor, Washington, DC, 20073, USA. brbiteman@gmail.com.
Surgical Endoscopy
|May 1, 2016
Summary
Laparoscopic lateral pancreaticojejunostomy offers an effective treatment for chronic pancreatitis, providing pain relief and improving quality of life for patients with a dilated pancreatic duct. This minimally invasive approach demonstrates successful outcomes in managing this complex condition.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Chronic pancreatitis is a progressive inflammatory disease causing irreversible pancreatic damage.
- Symptomatic chronic pancreatitis with a dilated pancreatic duct often requires surgical intervention, traditionally via open approach.
- Laparoscopic techniques for pancreaticojejunostomy are emerging due to their potential benefits.
Observation:
- A 45-year-old male with chronic alcohol abuse presented with abdominal pain and diagnosed chronic pancreatitis with a dilated pancreatic duct and obstructing calcified stone.
- A laparoscopic lateral pancreaticojejunostomy (Puestow procedure) was performed using a 5-port technique.
- The procedure involved a 15-cm pancreatic ductotomy, stone clearance, and a hand-sewn Roux-en-Y reconstruction.
Findings:
- The patient experienced an uncomplicated recovery, with bowel function returning on postoperative day 4 and discharge on day 5.
- At 12- and 26-month follow-up, the patient remained pain-free, off narcotics, and maintained an improved quality of life.
- Long-term alcohol abstinence was a critical factor in the patient's sustained recovery.
Implications:
- Laparoscopic lateral pancreaticojejunostomy is a viable and effective minimally invasive option for managing chronic pancreatitis with ductal dilation.
- This approach can lead to significant long-term pain reduction and enhanced quality of life.
- Successful outcomes highlight the importance of patient selection and adherence to lifestyle modifications, such as alcohol cessation.
