What is lateral Pancreaticojejunostomy for chronic pancreatitis?
During a Puestow procedure, also known as a lateral pancreaticojejunostomy, the abdomen is opened with an incision from the lower breastbone to the belly button. The pancreas is exposed and the main pancreatic duct is opened from the head to the tail of the pancreas.
When is a Puestow procedure carried out?
A Puestow procedure may be considered in patients with severe abdominal pain associated with chronic pancreatitis and pancreatic duct dilation (>6 mm) associated with obstruction and strictures.
What is Roux en Y Pancreaticojejunostomy?
A Roux-en-Y lateral pancreaticojejunostomy (Puestow procedure) provides pain relief through ductal drainage while preserving pancreatic parenchyma. The pancreatic duct is opened head-to-tail, and the Roux jejunal limb is sutured to the pancreatic capsule around the “filleted” duct to provide a drainage route.
Why is puestow done?
A Puestow procedure is indicated for the treatment of symptomatic chronic pancreatitis patients with pancreatic ductal obstruction and a dilated main pancreatic duct. The main pancreatic duct needs to be 6mm in diameter in the body of the pancreas for this procedure to be possible.
Can chronic pancreatitis be cured with surgery?
The most common reason surgical treatment is undertaken is to treat pain associated with chronic pancreatitis. One successful operation, known as the Puestow procedure, improves the drainage of the pancreas by draining the pancreatic duct into the small intestine.
Can pancreatitis be cured by surgery?
Mild acute pancreatitis usually goes away in a few days with rest and treatment. If your pancreatitis is more severe, your treatment may also include: Surgery. Your doctor may recommend surgery to remove the gallbladder, called cholecystectomy, if gallstones cause your pancreatitis.
Why is a Pancreaticojejunostomy performed?
Lateral pancreaticojejunostomy (LPJ), also known as the Puestow procedure, is a complex surgical procedure reserved for patients with refractory chronic pancreatitis (CP) and a dilated pancreatic duct.
What is modified Puestow procedure?
Lateral pancreaticojejunostomy or the modified Puestow procedure is the most common technique employed in the surgical management of chronic pancreatitis. This procedure provides definitive pain control and prevents progression of pancreatic damage when the cause is obstruction.
What does Roux-en-Y stand for?
Gastric bypass, also called Roux-en-Y (roo-en-wy) gastric bypass, is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine.
Why is Roux-en-Y called that?
The Roux-en-Y is named after the Swiss surgeon César Roux (1857-1934), who was Chief of Surgery at the county hospital of Lausanne and following the opening of the new University of Lausanne, in 1890, was its inaugural Professor of External Pathology and Gynecology 4.
What is the best treatment for chronic pancreatitis?
For patients with chronic pain that cannot be controlled otherwise, we may recommend medication.
- Enzyme Therapy.
- High-protein, High-calorie Diets.
- Puestow Procedure (Longitudinal Pancreaticojejunostomy)
- Whipple Procedure (Pancreaticoduodenectomy)
- Total Pancreatectomy and Auto Islet Transplantation.