Laparoscopic lateral pancreaticojejunostomy : A new remedy for an old ailment

• Published in: Surgical endoscopy Vol. 20; no. 3; pp. 458 - 461
• Main Authors: PALANIVELU, C, SHETTY, R, JANI, K, RAJAN, P. S, SENDHILKUMAR, K, PARTHASARTHI, R, MALLADI, V
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.03.2006; Springer Nature B.V
• Subjects: Adolescent; Adult; Anastomosis, Surgical - methods; Biological and medical sciences; Child; Decompression, Surgical - methods; Digestive system. Abdomen; Dilatation, Pathologic; Endoscopy; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Length of Stay; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pancreatic Ducts - pathology; Pancreatic Ducts - surgery; Pancreaticojejunostomy - methods; Pancreatitis, Chronic - surgery; Punctures; Chronic; Chronic pancreatitis; Pancreatitis; Digestive diseases; Laparoscopy; Endoscopy; Lateral pancreatojejunostomy; Pancreatic disease
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-005-0680-x

Lateral pancreaticojejunostomy is considered as the standard surgery for chronic pancreatitis. Yet there are very few reports of this procedure being done laparoscopically. We present our experience with laparoscopic lateral pancreaticojejunostomy till date and describe our technique. Since 1997, we have done 12 laparoscopic lateral pancreatojejunostomies. There were 9 females and 3 males and the average age was 29.3 years. The indication for surgery in all patients was intractable abdominal pain and significant weight loss. Additionally, two patients were also suffering from pancreatic ascites. The average diameter of the pancreatic duct was 14.7 mm. We used a four-port technique. All surgeries were completed without any conversion to open surgery. Post-operatively, there were no major morbidity and nil mortality. The average operating time was 172 minutes. Post-operative stay was short (average 5 days) and on median follow-up of 4.4 years, 83.3% patients had complete pain relief while 16.7% had partial relief. All patients had significant weight gain. Laparoscopic lateral pancreaticojejunostomy is safe, effective and feasible in experience hands. Mastery of intracorporeal knotting and suturing techniques is mandatory before embarking on this surgery.