Fully laparoscopic pancreaticojejunostomy, Puestow procedure (with video)

Chronic pancreatitis usually requires medical treatment and, in rare cases, surgical intervention. The most frequent cause of consultation is chronic pain that is difficult to manage, and therapeutic options such as endoscopy can resolve most problems without surgery. However, when these options fail, surgical management is necessary. The most common surgery is a lateral pancreatic bypass or Puestow surgery. We present the case of a 31-year-old patient with unspecific abdominal discomfort. Abdominal ultrasonography showed significant dilation of the pancreatic duct (18 mm). Abdominal magnetic resonance imaging showed an impacted stone in the head of the pancreas and pancreas divisum. Resolution with endoscopy was attempted, but the pancreatic duct could not be accessed due to impacted lithiasis. After discussion in a multidisciplinary committee, surgical treatment was recommended, and a fully laparoscopic Puestow surgery was performed.