**6. Surgery for the complications of chronic pancreatitis**

Surgery for the complications of CP should be individualized to cater to a patient's specific morphology and clinical presentation.

#### **6.1 Biliary obstruction**

Choledocho-duodenostomy or hepatico-jejunostomy using a Roux-en-Y loop are the preferred procedures to resolve isolated biliary obstruction although the former may result in enteric refux and a sump-like syndrome. Cholecysto-enterostomy has been associated with poor results and has fallen into disfavour. A Hepatico-jejunostomy may be included in the Roux loop used to drain the pancreatic duct in dedicated drainage, resection or hybrid procedures performed to relieve pain. Alternatively, the CBD may opened within the surgically created cavity in the pancreatic head during the Berne procedure.
