Middle segment pancrectomy avoided in

.95% subtotal pancreatectomy. * Distal pancreatectomy--Spleen, body and tail of the pancreas are removed--Child's operation. * Puestow's operation--As the duct is dilated more than 8 mm, duct can easily be opened longitudinally. After removing all stones from the duct, it is anastomosed to the jejunum as Roux-en-Y anastomosis. In Puestow's operation spleen is removed. * Paington - Rochelle operation: Here longitudinal pancreaticojejunostomy is done using almost entire laid open pancreatic duct. Spleen is retained in this procedure. This is now commonly done procedure. * Total pancreatectomy is indicated when entire gland is diseased. It relieves the pain and also prevents the diseased pancreas from turning into malignancy. Patient has to take insulin and oral pancreatic enzymes permanently (brittle diabetes). * The cause is treated like cholecystectomy for gall stones. ref:SRB&;S manual of surgery,ed 3,pg no 629