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Patients with chronic pancreatitis and a blocked and dilated pancreatic duct may be treated with a Puestow procedure, also known as lateral pancreaticojejunostomy. A blocked and dilated duct is often caused by pancreatic duct stones, which are hardened deposits that often form because of long-term inflammation. They can block the flow of digestive enzymes.

In the Puestow procedure, the pancreatic duct, which runs along the body of the pancreas from end to end, is opened along its length and drained into the small intestine.

When the pancreatic head—the widest part of the organ that sits toward the center of the abdomen—is the main location of damaged tissue, a pancreatic head resection, or pancreaticoduodenectomy, may be recommended. This surgery is also known as a Whipple procedure.

During the surgery, doctors remove the head of the pancreas, the first section of the small intestine or duodenum, the gallbladder, and the portion of the common bile duct that empties into the duodenum. A portion of the stomach near the duodenum may also be removed.

Patients who have a large amount of damaged tissue in the head of the pancreas and a dilated pancreatic duct may benefit from a Frey procedure. This surgery, which combines elements of the Whipple and Puestow procedures, removes inflamed tissue from the pancreatic head and drains the pancreatic duct into the small intestine.

In the Beger procedure, only the head of the pancreas is removed. The duodenum is preserved, therefore helping preserve digestive function. This procedure may benefit patients who have inflammation in the head of the pancreas but a healthy duodenum.

In patients with scarring that is mostly in the tail (distal) portion of the pancreas, a distal pancreatectomy may be beneficial. The procedure may also be appropriate for those with a disconnected pancreas, a condition that can occur with severe pancreatitis. In these cases, inflammation can damage the main pancreatic duct, causing the tail of the pancreas to become separated from the rest of the gland and preventing digestive enzymes from draining properly.

A distal pancreatectomy involves surgically removing the tail of the pancreas and sometimes part of the body of the gland.

In some patients with chronic pancreatitis, a total pancreatectomy with islet autotransplantation (TPIAT) can help alleviate pain and improve quality of life.

In this procedure, our surgeons remove the pancreas and preserve and process it in the operating room, separating out the islets of Langerhans. These are clusters of cells that make insulin and other hormones that regulate blood glucose. The islet cells are immediately returned to the patient during the operation, into the liver, where they become established and work to prevent diabetes.

The procedure is an autotransplantation, which means that patients receive back their own cells, so they do not have to take medications to prevent rejection, as they would with other types of transplants.

Patients with hereditary or genetic pancreatitis, pancreatitis with no identifiable cause, small duct pancreatitis, which is inflammation that affects the smaller branches of the pancreatic duct rather than the main duct, and recurrent acute pancreatitis are the most common candidates for this procedure. Those who have undergone other procedures for pancreatitis but have continued symptoms may benefit from total pancreatectomy with islet autotransplantation.

���ϸ����� Langone is one of the few centers in the world that offers islet autotransplantation. Our surgeons are among the most experienced in the world at this procedure.

Recovery time after surgery varies based on the procedure and your health. Some people may require supportive care in the hospital for weeks or longer until their condition stabilizes, and the pancreas begins to function normally. During this time, ���ϸ����� Langone’s intensive care specialists and nursing team carefully monitor you and provide supportive care, including pain management as necessary.