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You are here: Home / Abstracts / Laparoscopic Longitudinal Pancreaticojejunostomy (Puestow) on a patient with a history of a RY gastric bypass and a pancreaticoduodenectomy (Whipple)

Laparoscopic Longitudinal Pancreaticojejunostomy (Puestow) on a patient with a history of a RY gastric bypass and a pancreaticoduodenectomy (Whipple)

Ariel Shuchleib, Pearl Ma, Ikemefuna I Akusoba, Aaron Sabbota, Daniel Swatrz, Keith B Boone, Kelvin D Higa. UCSF Fresno

This is a case from a 45 y/o F with a history of a laparoscopic RY gastric bypass on 2005 who developed a highly differentiated pancreatic neuroendocrine tumor that was resected with a laparoscopic pancreaticoduodenectomy (Whipple procedure) on 2015.

She had multiple episodes of pancreatitis that were attributed to a stricture at the pancreaticojejunostomy that required a laparoscopic dilation of the anastomosis a year after the surgery but despite that she still had recurrent episodes of pancreatitis.

She had an MRCP that showed ectatic pancreatic ducts with areas of stricturing.

An endoscopic placement of a stent was attempted but unfortunately was unsuccessful so it was decided than a laparoscopic longitudinal pancreaticojejunostomy was the best approach.

The procedure was done without complications and the patient had an uneventful recovery and good results postoperatively on the short term.

This case represents an interesting case because of the unusual anatomy of this patient due to the 2 previous procedures done on this region with a creative approach to solve her problem.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93605

Program Number: V065

Presentation Session: Exhibit Hall Theater Video Session II

Presentation Type: EHVideo

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