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Updated: Jun 28, 2025
Laparoscopic Duodenum-Preserving Pancreatic Head Resection via Inferior Infracolic Approach: A Surgical Approach for Benign Lesions
Published on: February 9, 2024
Pancreas preserving duodenectomy (PPrD)
Christine Chung1, Stephanie Stovall1, Stella R Biehl2
1Virginia Mason Franciscan Health (VMFH), 1100 9th Ave, Seattle, WA, 98101, USA.
Background:
Pancreaticoduodenectomy has been the standard of care for managing duodenal neoplasms, but recent studies show similar overall and disease-specific survival after pancreas-preserving duodenectomy (PPrD) with potentially less morbidity.
Methods:
Retrospective cohort of all adult (age >18) patients who underwent PPrD with curative intent of a neoplasm in or invading into the duodenum at our institution from 2011 to 2022 (n = 29), excluding tumors involving the Ampulla of Vater or the pancreas. Statistical analyses were performed using STATA.
Results:
R0 resection was achieved in 93 % patients. Ten (34.4 %) experienced postoperative complications (13.7 % within Clavien-Dindo III-V). PPrD patients had lower rates of pancreatic leak, delayed gastric emptying, and deep surgical site infection.
Conclusions:
In this case series, we demonstrate PPrD is safe and effective, with a high rate of complete resection and lower complication rate than that seen in pancreaticoduodenectomy.
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The broad head of the pancreas lies within the loop formed by the duodenum, while its slender body reaches towards the spleen. The tail of the pancreas is short...