Puestow procedure [Case 22]

OR Footage

Summary of surgeons' findings and slowing down moments:

Dr. Gallinger’s procedure-specific moments:

  1. Finding pancreatic plane: avoid splenic vein, artery; duodenojejunal flexure
  2. Locate pancreatic duct, ductotomy
  3. Pancreaticojejunostomy, side-to-side anastomosis

Dr. Greig’s procedure-specific moments:

  1. Preserve gastroepiploic vessels
  2. Obtain adequate exposure of anterior pancreas surface
  3. Intraoperative ultrasound to confirm duct
  4. Longitudinal ductotomy
  5. Prepare adequate length of jejunum for Roux loop
  6. Careful anastomosis, especially at corners
  7. Close mesenteric defect

Watch the following videos from the operation to see some of the key moments in the case.

Dissecting pancreatic plane, prepare Roux limb
Ductotomy
Pancreaticojejunostomy
<< Previous Next >>

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

Views and opinions expressed in all videos and module content are those of the individual surgeon and solely intended for surgical education purposes. We do not endorse any product, treatment or therapy.

Corporate Partners

Ethicon logo
Angiodynamics logo
Sirtex logo
Baxter logo

If you are interested in becoming a Corporate Partner of the IHBPA please contact industry@ihpba.org

Find out more