Related Experiment Video
Updated: May 16, 2025
Laparoscopic Duodenum-Preserving Pancreatic Head Resection via Inferior Infracolic Approach: A Surgical Approach for Benign Lesions
Published on: February 9, 2024
Duodenal-preserving pancreatic head resection: a pictorial essay
Meghan E Lark1, Thomas K Maatman1, Nicholas J Zyromski1
1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States.
Purpose:
Chronic pancreatitis is a devastating disease associated with irreversible parenchymal fibrosis and organ dysfunction. Patients with severe disease refractory to medical and endoscopic interventions may require surgical intervention to address symptoms and disease complications. This review explores the background, indications, and visual elements of duodenal-preserving pancreatic head resection (DPPHR) as a procedure for patients with chronic pancreatitis affecting the pancreatic head.
Methods:
The most common DPPHR procedures, including those introduced by Beger, Frey, Izbicki, and Berne, were reviewed and described with a focus on anatomic illustration and indications for operative selection. Additionally, 2 creative modifications of DPPHR were explored as surgical options for patients with anatomic variants of chronic pancreatitis.
Results:
The heterogeneous nature of chronic pancreatitis lends to a myriad of surgical options for DPPHR. Surgical selection is guided by individual patient disease, including pancreatic ductal anatomy and location of inflammation in the pancreas.
Conclusion:
Optimal preoperative patient selection and intraoperative decision-making are keys in prioritizing pain relief and organ preservation in chronic pancreatitis. It is important for both surgeons and clinicians in various disciplines who manage patients with chronic pancreatitis to have an overview of the variants of DPPHR to inform the long-term care of these patients.
