Re-do Laparoscopic Longitudinal Pancreaticojejunostomy in a Patient With Chronic Pancreatitis and Failed Open Peustow’s Procedure

Srikanth Gadiyaram, MS MCh, Neel Shetty, DNB, Sunil Alur, DNB, Ganesh Shenoy, MS. Institute of Gastroenterology, BGS Global Hospitals, Bangalore

 

We here present a 20 yrs old female patient who had undergone open pancreatico-jejunostomy for chronic calculous pancreatitis 2 years ago. Patient continued to have recurrent episodes of upper abdominal pain radiating to back and weight loss after the surgery. She doesn’t have any history suggestive of pancreatic exocrine/ endocrine insufficiency. On evaluation, CECT-abdomen showed atrophic pancreas with stones in head, body and tail region of pancreas; largest measuring 13mm. calculi were seen clustered in the head and tail region. There was no peripancreatic collection or mass lesion. After basic haematological and biochemistry work-up she underwent laparoscopic lateral pancreatico-jejunostomy. Pnueumoperitoneum was created by Hassan’s open method. A four- port technique was used. After an initial diagnostic laparoscopy and adhesiolysis, lesser sac was entered and a wide exposure of lesser sac was achieved by aided gastric traction sutures. The Roux- loop of jejunum created during the previous surgery was identified and defined. Pancreatic duct was widely opened along its entire extent. All stones were cleared. Pancreatic duct was anastomosed to subjacent lying jejuna Roux-limb with interrupted sutures of no. 2-0 monocryl sutures. Abdominal drain was placed and anchored. Umbilical port was closed with no. 1-0 vicryl suture and skin of ports site closed with no. 3-0 monocryl, subcuticular sutures. She was allowed oral clear liquids on post-op day 1 and liquid diet on post-op day 2. She made an uneventful postoperative recovery. At three month follow-up she had complete relief of abdominal pain and weight gain of 8kgs.


Session Number: Poster – Poster Presentations
Program Number: P354
View Poster

« Return to SAGES 2012 abstract archive