The concept of draining an apparently obstructed main pancreatic duct was first addressed by opening either the proximal end of the pancreatic duct at the ampulla by doing a sphincterotomy or at the distal end of the pancreatic duct by removing the tail (Duval procedure). Puestow is credited with the concept of a longitudinal incision along the main pancreatic duct through the body and the head of the pancreas. This procedure was first described as a modification of a Duval procedure and therefore included resection of the pancreatic tail. Partington and Rochelle determined that a tail resection was unnecessary and carried out only a side-to-side lateral pancreaticojejunostomy. The principle of the procedure is to decompress an apparently obstructed main pancreatic duct (and maybe to also decompress the pancreatic parenchyma - the pancreatic compartment syndrome suggested by Reber). This assumption is based on the fact that the pancreatic duct is markedly dilated, suggesting a restriction to flow.
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