Lateral Pancreaticojejunostomy (Puestow Procedure)
Surgical drainage of the dilated pancreatic duct into the jejunum — gold standard for chronic pancreatitis pain relief.
What is Lateral Pancreaticojejunostomy (Puestow Procedure)?
The Puestow procedure opens the dilated pancreatic duct longitudinally along its entire length and sutures a loop of jejunum directly to it, permanently decompressing the ductal system and relieving the intraductal hypertension that causes chronic pancreatitis pain.
Dr. Tagore Mohan Grandhi performs the Puestow procedure for chronic pancreatitis with a dilated main pancreatic duct (over 7 mm). Over 80% of patients achieve durable long-term pain relief.
Suitable for patients with chronic pancreatitis and a dilated main pancreatic duct (over 7 mm) with chronic abdominal pain, particularly those who have not responded to endoscopic stenting over 12 months.
How the Procedure Works
Pre-operative Imaging
MRCP and CT confirm ductal dilation, stricture location, and dominant inflammatory head mass. Nutritional status optimised before surgery.
Pancreatic Exposure
Upper midline incision. Stomach and transverse colon retracted. Main pancreatic duct identified by needle aspiration.
Longitudinal Ductotomy
Main pancreatic duct opened along its entire length from tail to head, removing all ductal strictures under direct vision.
Pancreaticojejunostomy
Defunctioned Roux-en-Y jejunal limb sutured to the full opened duct length. Drainage permanent — no stent exchanges required.
Recovery
Oral fluids day two. Discharged in 5–7 days. Pancreatic enzyme replacement continued. Pain response assessed at 6-week follow-up.
Outcomes
Who Needs This Treatment?
- →Gold standard surgical drainage for dilated duct chronic pancreatitis
- →80%+ of patients achieve durable long-term pain relief
- →Permanent ductal decompression — no repeat procedures needed in most patients
- →Preserves pancreatic endocrine and exocrine function unlike resection
The Puestow procedure gives chronic pancreatitis patients something they often thought impossible — lasting freedom from the relentless pain that has dominated their lives. The results are consistently rewarding.
— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad
Lateral Pancreaticojejunostomy (Puestow Procedure) Cost in Hyderabad
The cost of Lateral Pancreaticojejunostomy (Puestow Procedure) in Hyderabad depends on factors such as pancreatic duct enlargement, severity of chronic pancreatitis, surgical complexity, hospital stay, and post-operative care.
For patients with dilated pancreatic ducts and persistent pain due to chronic pancreatitis, the approximate cost of Lateral Pancreaticojejunostomy ranges between ₹2,50,000 and ₹4,50,000.
| Procedure | Approximate Cost Range |
|---|---|
| Lateral Pancreaticojejunostomy (Puestow) | ₹2,50,000 – ₹4,50,000 |
The final cost may vary depending on individual health factors, surgical findings, hospital admission duration, and recovery requirements.
Factors That Influence Puestow Procedure Cost
The overall cost may depend on:
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Extent of pancreatic duct disease: The degree of duct dilation, obstruction, and chronic inflammation can influence surgical planning.
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Pre-operative evaluation: Imaging, pancreatic function tests, blood investigations, and medical assessments may affect the overall cost.
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Surgical complexity: The procedure requirements, anaesthesia, hospital stay, and post-operative monitoring can influence the final estimate.
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Long-term pancreatic care: Patients may require ongoing management, including enzyme supplementation, nutritional guidance, and follow-up consultations.
Is Puestow Procedure Covered by Insurance?
Lateral Pancreaticojejunostomy performed for medically necessary treatment of chronic pancreatitis may be covered by health insurance. Coverage depends on your policy benefits, insurer approval, and documentation requirements. Our insurance support team can assist with policy verification, required documents, and cashless approval procedures.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Tagore Grandhi
Orthopaedic & Joint Replacement Surgeon
During consultation, Dr. Tagore Mohan Grandhi, Bariatric & GI Surgeon at Lux Hospitals, will assess your pancreatic condition, imaging findings, and treatment history to determine whether Puestow Procedure is appropriate. He will explain the surgical procedure, expected outcomes, recovery process, and provide a personalised cost estimate based on your condition.
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