Lateral pancreatico-jejunostomy: a case series

Aaditya S. Bhatwal, Amit J. Patil, Nikhil U. Shirole, Pallavi A. Bhatwal, Shriram R. Bhatwal


Chronic pancreatitis and tropical pancreatitis lead to frequent abdominal pain. To reduce this pain, lateral pancreaticojejunostomy (LPJ) is the most common surgical procedure. Despite the evidence available for the effectiveness of surgical therapy, the decision for indication, type, and timing of surgical intervention has always been debated. In this case series we make an attempt to define the possible timing of the procedure and the category of patients who might benefit from it. 14 out of 65 patients who were evaluated from July 2018 to December 2021 were included in this study. All patients were observed with pain in the abdomen, weight loss, steatorrhea, and malabsorption while none of the patients had pancreatic head mass as per cross-sectional imaging. Fourteen patients with confirmed chronic atrophic pancreatitis with severe symptoms and dilatation of the pancreatic duct were operated upon. Three of these were considered failures since they continued to have no weight gain and either pain or malabsorption. The failures were mainly due to impaired pancreas because of chronic disease and not due to failure of the procedure. Chronic pancreatitis cases, with a short duration of illness, have a better chance of success in surgery. We conclude that one can resort to LPJ in cases that do not respond to medical therapy, continue to suffer from pain, malabsorption, and weight loss. It is a relatively safe procedure that provides good pain relief with low postoperative morbidity, further preventing exacerbations and maintaining appropriate pancreatic exocrine and endocrine functions.


Pancreatitis, LPJ, Abdominal pain

Full Text:



Issa Y, Boermeester MA. Management of chronic pancreatitis: more pain than gain? BJS. 2021;108:1397-9

Kim YH, Jang SI, Rhee K, Lee DK. Endoscopic Treatment of Pancreatic Calculi. Clin Endosc. 2014;47:227-35.

Nag HH, Arvinda PS, Sachan A, Saluja SS, Sachdeva S, Chandra S. Laparoscopic Lateral Pancreatico-jejunostomy-the Technique and Early Experience. Indian J Surg. 2019;81:51-6.

D’Haese JG, Cahen DL, Werner J. Current Surgical Treatment Options in Chronic Pancreatitis. Pancreapedia: Exocrine Pancreas Knowledge Base Version 1.0. 2016;26.

Bouwense SAW, Kempeneers MA, Van Santvoort HC, Boermeester MA, Van Goor H, Besselink MG. Surgery in Chronic Pancreatitis: Indication, Timing and Procedures. Visc Med. 2019;35:110-8.

Islam SR, Rahman S,Talukdar S, Sarkar SA, Poran S. Lateral Pancreato-Jejunostomy in Chronic Pancreatitis:An appraisal of 32 cases. Arch Surg Clin Res. 2020;4:001-5.

Sielezneff I, Malouf A, Salle E, Brunet C, Thirion X, Sastre B. Long Term Results of Lateral Pancreaticojejunostomy for Chronic Alcoholic Pancreatitis, Eur J Surg. 2000;166:58-64.

Sahoo A, Swain N, Mohanty A. Diabetes Status After Lateral Pancreaticojejunostomy and Frey’s Procedure in Chronic Calcific Pancreatitis: An Observational Study. Cureus. 2015;14(2):e21855.

Tattersalle SJN, Apte MV, Wilson JS. A fire inside: current concepts in chronic pancreatitis. Intern Med J. 2008;38(7):592-8.

Kangas-Dick A, Khan U, Awoniyi O, Waqar S, Tun NN, Viswanathan K et al. A Case of Chronic Calcific Nonalcoholic Pancreatitis. Case Reports in Gastrointestinal Med. 2016;2963681.