Modified Partington–Rochelle procedure for chronic calcifying pancreatitis with pancreatic pseudocyst in an adolescent: a case report

Abstract

Chronic calcifying pancreatitis (CCP) is rare in adolescents and is associated with significant morbidity, including chronic pain. Although endoscopic and minimally invasive techniques have expanded treatment options, surgery remains the cornerstone of management in complicated cases. The Partington-Rochelle (PR) procedure is widely used, but long-term outcomes may be suboptimal when associated complications are present. We report the case of a 15-year-old Senegalese girl presenting with chronic epigastric pain and weight loss over two years. Imaging demonstrated CCP with marked dilation of the main pancreatic duct and a large pancreatic pseudocyst. Given extensive ductal calculi, the associated pseudocyst, and limited access to advanced endoscopic therapy, surgical management was selected as first-line treatment. A modified PR procedure combined with cholecystectomy, choledochoduodenostomy, and cystogastrostomy was performed. Postoperative recovery was uneventful. A modified PR procedure combined with biliary and cystic diversion may provide durable symptom relief and favorable long-term outcomes in selected adolescents with complicated CCP.