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Modified Puestow (Partington and Rochelle Procedure) for chronic lithiasic pancreatitis in a modern endoscopic era

Meenal Mapari, Ajay Ashok Gujar, Mukul Mapari, Amrita Gujar.

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Background: Chronic pancreatitis has been defined as a continuing inflammatory disease of the pancreas characterized by irreversible morphological changes. These changes typically cause pain and loss of exocrine and endocrine pancreatic function.
Modified Puestow is the best available method to relieve the symptoms associated with chronic pancreatitis especially pain. As a consultant, I performed my first modified Puestow in February 1993 and found excellent results without any complications in consecutive 27 years. In a later era, I operated only on those patients who were failed in endoscopic management.
Materials and Methods: From February 1993 to January 2019, we did multiple types of procedures as per case demand in chronic pancreatitis. 49 cases of chronic pancreatitis were operated on for modified Puestow. All selected patients had haematological and radiological workup. MRCP of all patients showing dilated pancreatic duct more than 7mm. in size. follow up after surgery was done from one year to 27 years.
Results: All 49 patients in short term to long term follow up were recovered well from pain and abdominal discomfort. Appetite improved and weight gain noted in the patients after surgery.
Conclusions: Modified Puestow is still a safe, simple and timely approved procedure for pain associated with chronic pancreatitis.

Key words: chronic pancreatitis with lithiasis, Partington and Rochelle pancreatico-jejunostomy, Modified Puestow’s.

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