Longitudinal Pancreaticojejunostomy (Puestow Procedure) - TVASurg

Case Description

The patient was a 61-year-old female with periampullary stricture of the duct of Santorini and duct of Wirsung.
Multiple pancreatic duct stents had been inserted in the duct of Santorini, but each had fallen out.
A longitudinal pancreaticojejunostomy (Puestow procedure) was performed.
Intraoperative ultrasound was used to locate the pancreatic duct, and splayed open to an adequate length in preparation for a side-to-side (longitudinal) pancreaticojejunostomy.
A Roux-en-Y limb was constructed, the stapled end of the Roux limb was positioned towards the spleen, and an opening was made along its antimesenteric border.
The longitudinal pancreaticojejunostomy was performed with two layers of anastomosis for the back and front wall.

MRI Scans

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3D MRCP

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