Skills in intracorporeal suturing and knot tying technique is mandatory. In chronic calculous obstructive pancreatitis decompression of the pancreatic duct and lateral pancreatojejunostomy with preservation of the tail end of the pancreas is the standard approach in conventional surgery. The same equivalent can be achieved by Laparoscopic approach. Among operations where laparoscopic suturing is required to be performed by intracorporeal method. I consider pancreatojejunostomy as one of the most difficult procedures.
Adequate experience is of utmost importance.
Our video presented in the 6th World congress Italy, was widely appreciated. Experience in intracorporeal knot tying and suturing is very essential to perform such anastomosis. It contains high concentration of pancreatic enzymes and lack of an epithelial lining. Persistence of a pseudocyst implies an ongoing communication with the pancreatic duct. ERCP is selectively done in patients with biochemical evidence of ampullary obstruction, all recurrent pseudocyst, pseudocyst arising months after recovery from pancreatitis.