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Updated: Mar 20, 2026
Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis
Published on: September 5, 2025
Laparoscopic side-to-side pancreaticojejunostomy for chronic pancreatitis in children
Kyoichi Deie1, Hiroo Uchida2, Hiroshi Kawashima3
1Department of Pediatric Surgery, University of Tokyo Hospital, Tokyo; Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
Insights
Laparoscopic pancreatic duct (PD) drainage is a rare but effective treatment for pediatric chronic pancreatitis unresponsive to other therapies. This minimally invasive approach offers cosmetic benefits and a low complication rate in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Chronic pancreatitis in children is uncommon and challenging to manage.
- Surgical intervention for pancreatic duct (PD) drainage is reserved for refractory cases.
- Therapeutic endoscopy may not always be successful.
Observation:
- Two pediatric patients with chronic pancreatitis underwent laparoscopic side-to-side pancreaticojejunostomy.
- Intraoperative ultrasonography guided the identification of the dilated PD.
- The procedure involved longitudinal splitting of the PD and a one-layered anastomosis.
Findings:
- The laparoscopic pancreaticojejunostomy was technically feasible and successfully performed.
- No intraoperative or postoperative complications were observed in either patient.
- The surgical technique demonstrated effectiveness in treating pediatric chronic pancreatitis.
Implications:
- Laparoscopic pancreaticojejunostomy is a viable and effective surgical option for pediatric chronic pancreatitis.
- This minimally invasive technique offers cosmetic advantages over traditional open surgery.
- Further studies may explore wider application in pediatric surgical practice.
Abstract:
Surgical pancreatic duct (PD) drainage for chronic pancreatitis in children is relatively rare. It is indicated in cases of recurrent pancreatitis and PD dilatation that have not responded to medical therapy and therapeutic endoscopy. We performed laparoscopic side-to-side pancreaticojejunostomy for two paediatric patients with chronic pancreatitis. The main PD was opened easily by electrocautery after locating the dilated PD by intraoperative ultrasonography. The dilated PD was split longitudinally from the pancreatic tail to the pancreatic head by laparoscopic coagulation shears or electrocautery after pancreatography. A laparoscopic side-to-side pancreaticojejunostomy was performed by a one-layered technique using continuous 4-0 polydioxanone (PDS) sutures from the pancreatic tail to the pancreatic head. There were no intraoperative or postoperative complications or recurrences. This procedure has cosmetic advantages compared with open surgery for chronic pancreatitis. Laparoscopic side-to-side pancreaticojejunostomy in children is feasible and effective for the treatment of chronic pancreatitis.
