Endoscopic versus surgical drainage of the pancreatic duct for chronic pancreatitis is beeing discussed and randomized clinical trial data is demonstrating better outcomes after surgical drainage. This is an illustrative case of a 48 yold woman that failed endoscopic treatment for severe chronic pancreatitis with pancreatic duct obstruction and underwent laparoscopic subtotal pancreatectomy after attempted laparoscopic puestow procedure. Laparoscopic attempted Puestow procedure and c spleen-preserving laparoscopic pancreatectomy for chronic pancreatitis with intraoperative pancreatograms.

Postoperative course was uneventful. The patient is essentially pain-free. Temporary postoperative insulin dependent diabetes has resolved. Hosptial stay was 2 days. There were no operative complications.

This video demonstrates the level of minimally invasive surgical care that can be offered to patients with chronic pancreatitis and ductal obstruction. The flexibility of the minimal invasive surgical approach for this clinical scenario is illustrated.