Novel method of pancreatojejunal reconstruction after spontaneous closure of previous lateral pancreatojejunostomy.

摘要

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.