Pancreato-biliary-duodenal interposition of isolated jejunal loop in the surgical treatment of selected cases of chronic pancreatitis.

Eight patients suffering from symptoms of chronic pancreatitis with dilation of Wirsung's and common bile ducts were selected for a double biliary and pancreatic diversion by interposition of two jejunal loops between these ducts and the duodenum. In three patients a single loop was used, performing an anastomosis on the proximal end to the Wirsung duct about 45 centimeters below the anastomosis between the common duct and the jejunum. The distal end of this loop was anastomosed end-to-side to the duodenum. In five patients two different jejunal loop were used. While the proximal end of one loop was anastomosed to the Wirsung duct, the proximal end of the second loop was anastomosed to the common bile duct. End-to-side anastomosis was then performed between the distal end of both loops and the duodenum. There were no deaths or serious complications. The minimum follow-up was twelve months and the maximum three and half years, all the patients being without symptoms and with normalization of the laboratory tests three months after operation.