CPT® Code 48548

A pancreaticojejunostomy, side-to-side anastomosis, commonly referred to as a Puestow-type operation, is a surgical procedure primarily indicated for patients experiencing severe pain due to chronic pancreatitis. This operation aims to alleviate pain by facilitating the drainage of pancreatic secretions directly into the intestine. The procedure involves making a significant abdominal incision that extends from beneath the breastbone to the navel, allowing the surgeon to access the pancreas effectively. Once the pancreas is exposed, the main duct of the pancreas is carefully opened from the head to the tail, which is crucial for the subsequent steps of the operation. A loop of jejunum, which is a part of the small intestine, is then brought up to create a connecting fistula. This connection is essential as it allows for the drainage of pancreatic fluids. The entire open pancreatic duct is sutured into the defunctionalized jejunal loop, resulting in a longitudinal pancreaticojejunostomy. This side-to-side anastomosis is designed to enable pancreatic secretions to flow directly into the intestine, thereby reducing the pressure within the pancreatic duct and alleviating the symptoms associated with chronic pancreatitis.