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Laparoscopic Puestow’s Procedure

Laparoscopic Puestow’s Procedure

Chronic pancreatitis is an inflammation of the pancreas which occurs over a period of time, leading to irreparable damage to the substance of the pancreas.

Why does the problem occur?

This can occur because of various reasons, the commonest being chronic alcohol abuse. Lesser common causes are autoimmune dysfunction, genetic mutations, such as cystic fibrosis etc. Patients commonly complain of nausea, vomiting, oily or fatty stools, and stabbing pain in the upper midline of the abdomen which radiates to the back usually occurring immediately after eating meals. The diagnosis can be made with various tests, such as ERCP, EUS, CT scan and MRCP.


Pain management is crucial and can be done both medically and surgically. Surgical management of pain from chronic pancreatitis is resorted to when maximal medical treatment fails. The commonest surgical procedure for chronic pancreatitis is a modified Puestow’s pancreatic-jejunostomy, which drains the pancreatic juices directly into the jejunum, hence bypassing any block due to stones, inspissated secretions etc. With the advent of technology and superior visualization, laparoscopic surgery of the pancreas has become a safe and feasible option. At Digestive Health Institute, we perform surgeries for chronic pancreatitis by the keyhole or laparoscopic method with minimal morbidity after surgery.