The main problem of chronic pancreatitis is managing the chronic pain. When pharmacological means fail, ablative procedures like coeliac plexus ablation or bilateral splanchnicectomy becomes necessary. These procedures are designed based on anatomy. Pancreatic duct and common bile duct obstruction are known complications of chronic pancreatitis and methods of treatment are essentially based on interpretation of images. We present a case history of a patient with chronic pancreatitis who underwent bilateral thoracoscopic splanchnicectomy and later laparoscopic cholecysto-jejunostomy for common bile duct obstruction.The importance of anatomy in diagnosis and treatment are highlighted.Anniestan A , Jayathilaka AB , Galketiya KB