Puestow procedure [Case 22]

Introduction

This is a case of a 44-year old woman who first presented 12 years ago with abdominal discomfort and pain. Imaging showed a dilated pancreatic duct that tapers to a stricture, but no specific etiology or evidence of malignancy was found. Her case was followed sporadically with imaging. Now, 10 years later, she returned with pain and an impressively large pancreatic duct measuring 2.7cm. Again, there is no evidence of a lesion and no stone disease. There is no dilatation in the biliary tree. Gallbladder is normal. She is not a diabetic and has no history of pancreatitis. A Puestow procedure with pancreaticojejunostomy reconstruction was recommended.

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Acknowledgements
Thank you to the HPB Surgeons who contribute their time and expertise. This content is made possible through educational grants from:
AHPBA IHPBA Ethicon

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