Laparoscopic Lateral Pancreaticojejunostomy and Roux-en-Y Reconstruction for an Obstructing Pancreatic Duct Stone after Open Whipple Operation

Fredrick Che, MD, Kelvin Higa, MD, Ashraf Haddad, MD, Keith Boone, MD, Saber Ghiassi, MD. UCSF Fresno

69 year old female with a history of an open whipple procedure in 2006 for a large duodenal diverticulum with inspissated bile which caused an obstruction at the ampulla of vater; presented now with nausea, vomiting and worsening epigastric pain. CT showed a large pancreatic duct stone and dilated pancreatic duct, which caused her symptoms. Due to two unsuccessful ERCP attempts to retrieve the stone, she underwent a laparoscopic lateral pancreaticojejunostomy and roux-en-y reconstruction for retrieval of the obstructing pancreatic duct stone. Post-operatively, her symtpoms resolved, was able to tolerate a diet, and was discharged home. She has been followed in clinic closely, where she is still doing well and is pain free.

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