title: Novel method of pancreatojejunal reconstruction after spontaneous closure of previous lateral pancreatojejunostomy.
abstract: Lateral pancreatojejunostomy is a well-documented procedure for pain relief in chronic pancreatitis with a dilated main pancreatic duct. However, a number of patients develop recurrence of pain at variable intervals after a successful drainage procedure. A 40-year-old patient with tropical chronic pancreatitis developed recurrence of pain 13 years after a lateral pancreatojejunostomy. Investigation demonstrated a dilated main pancreatic duct. Re-exploration revealed a near complete closure of the previous lateral pancreatojejunostomy. A novel method of pancreatojejunal reconstruction was performed. Patient is pain-free after a follow-up of 18 months since surgery. The long-term status of lateral pancreatojejunostomy remains unclear. Our case documents, probably for the first time in published literature, a near total spontaneous closure of a previous lateral pancreatojejunostomy that was responsible for recurrence of pain. Our method of pancreatojejunal reconstruction adds to the armamentarium of the pancreatic surgeon.
authors.affiliation: Department of General Surgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India.
authors.forename: Shailesh V
authors.initials: SV
authors.lastname: Shrikhande
authors.forename: Vinayak N
authors.initials: VN
authors.lastname: Shrikhande
authors.forename: Anand G
authors.initials: AG
authors.lastname: Nande
authors.forename: Kishor
authors.initials: K
authors.lastname: Adyanthaya
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002758:Cholangiography; D002908:Chronic Disease; D004108:Dilatation, Pathologic; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts / Q000473:pathology*; D010193:Pancreaticojejunostomy / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery*; D012086:Reoperation