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Updated: Jul 15, 2025

Robotic D3 Partial Duodenal Resection with Primary Side-to-Side Anastomosis

Robotic D3 Partial Duodenal Resection with Primary Side-to-Side Anastomosis

Published on: December 15, 2023

Segmental Duodenal Resections: Toward Defining Indications, Complexity, and Coding.

Devanshi D Patel¹, Ahmad B Abdulkarim^2,3, Stephen W Behrman⁴

¹Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA. devanshipatelmd@gmail.com.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract

|September 25, 2023

Summary

This summary is machine-generated.

Segmental duodenal resections are complex but safe for various pathologies. Current coding systems may not accurately reflect the complexity and resource intensity of these unique surgical procedures.

Keywords:

CPT Coding Complexity Duodenal resection RVU

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Area of Science:

Gastrointestinal Surgery
Surgical Oncology
Surgical Outcomes Research

Background:

Segmental duodenal resections are infrequently performed and technically demanding.
These procedures require careful consideration due to the duodenum's proximity to vital structures like the biliary tree, pancreas, and mesenteric vessels.

Purpose of the Study:

To evaluate the indications, surgical strategies, and patient outcomes for duodenal resections.
To advocate for a distinct Current Procedural Terminology (CPT) and Relative Value Unit (RVU) structure for duodenal resections.

Main Methods:

Retrospective review of 31 patients undergoing isolated and partial duodenal resection between 2008 and 2023.
Analysis of clinical presentation, diagnostic methods, operative details, 90-day morbidity and mortality, and survival outcomes.

Main Results:

The study identified 31 patients, predominantly female, with a median age of 61.
Common reconstruction involved side-to-side duodenojejunostomy; intraoperative evaluation of the biliary tree was used in 11 patients, increasing operative time.
Procedure-related morbidity was 23% with one 90-day mortality; median postoperative stay was 9 days. Pathologies included benign and malignant neoplasms.

Conclusions:

Duodenal resections are effective for treating diverse duodenal pathologies.
These procedures involve significant operative times, prolonged hospital stays, and complication rates comparable to pancreatic resections.
The findings support the need for revised CPT and RVU systems to better define and value duodenal resections for research and practice.