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Related Experiment Videos

Pancreas-sparing duodenectomy: classification, indication and procedures.

H Nagai1, M Hyodo, K Kurihara

  • 1Department of Surgery, Jichi Medical School and Nasu Minami Hospital, Tochigi, Japan. nagaihd@jichi.ac.jp

Hepato-Gastroenterology
|August 3, 1999
PubMed
Summary

Pancreas-sparing duodenectomy (PSD) is a viable surgical option for extensive duodenal diseases. While complications occurred in critically ill patients, survivors showed good biliopancreatic function, suggesting PSD’s applicability.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Abdominal Surgery

Background:

  • Advances in surgical anatomy enable duodenum-preserving pancreatic head resections.
  • Pancreas-sparing duodenectomy (PSD) lacks systematic study, with varied procedures reported under this name.

Purpose of the Study:

  • To evaluate the applicability and outcomes of pancreas-sparing duodenectomy (PSD) in patients with extensive duodenal lesions.

Main Methods:

  • PSD was performed on 6 patients with diverse duodenal conditions (trauma, MALT lymphoma, necrosis, bleeding, leiomyosarcoma, stenosis).
  • Surgical techniques varied, including preserving the papilla of Vater and duodenum, transplanting a duodenal button with the papilla, or excising the intrapapillary portion of the major papilla.

Main Results:

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  • Two patients died from underlying conditions unrelated to surgery.
  • Four patients survived without anastomotic insufficiency; three had normal biliopancreatic function post-operatively.
  • One patient with papilla excision experienced asymptomatic contrast regurgitation into ducts, with no detected liver or pancreatic dysfunction up to 7 months.

Conclusions:

  • Pancreas-sparing duodenectomy (PSD) is applicable in clinical practice for selected duodenal pathologies.
  • Standardized classification of PSD procedures is necessary, considering indications, techniques, and long-term biliopancreatic function outcomes.