Longitudinal Pancreaticojejunostomy (Puestow Procedure)
DATE AND TIME: [Date and time]
URGENCY: Elective / Non-elective
SURGEON: [Name]
ASSISTANT: [Name / None]
ANAESTHETIST: [Name]
OPERATION: Longitudinal Pancreaticojejunostomy (Puestow Procedure)
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: IV cephalosporin at induction. VTE prophylaxis.
DVT PROPHYLAXIS: [Agent / mechanical / Not indicated]
POSITION: Supine. Nasogastric tube and urinary catheter. Intraoperative USS available.
INDICATION:
Chronic pancreatitis with refractory pain unresponsive to medical management. Preoperative imaging confirms dilated main pancreatic duct (typically >7 mm) throughout a generally atrophic gland — duct dilation extends from head to tail. [Previous endoscopic treatment failed]. Preoperative analgesia and nutritional optimisation performed.
INCISION: [Describe incision]