CASE DESCRIPTION
- The patient was a 33-year-old female with ampullary and pancreatic stones.
- A longitudinal pancreaticojejunostomy (Puestow procedure) was planned.
- Localization can be challenging in chronic pancreatitis cases due to collapsed ducts. The pancreatic duct was localized with intraoperative ultrasound and palpation.
- After the duct was localized, a longitudinal incision was be made on the anterior surface of the pancreas to open the main pancreatic duct. Pancreatic stones were carefully extracted.
- 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.
