Puestow Procedure

The Puestow procedure has been performed with much success in treating pain associated with chronic pancreatitis for more than 50 years. It has a success rate of 70-90 percent with a low rate of complications and very low mortality rate. MUSC is recognized nationally for expertise with this procedure.

During the Puestow procedure, the abdomen is opened with an incision from the lower breastbone to the navel. The pancreas is exposed and the main pancreatic duct is opened from the head to the tail of the pancreas. The opened pancreatic duct is then connected to a loop of small intestine so that the pancreas drains directly into the intestine. The procedure takes two to three hours to complete.

The Puestow procedure is typically performed when a patient has chronic pancreatitis with dilated pancreatic ducts due to gallstones, alcohol abuse or genetic factors.

The Puestow procedure is also known as a lateral pancreaticojejunostomy. It can be used in combination with electrohydraulic lithotripsy (EHL) to clear the head of the pancreas of obstructing stones. Another variation of the Puestow procedure is the Frey procedure, which may be more effective if the pancreatic head is not draining properly.

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