[Experience in 110 pancreatoduodenal resections]

Area of Science:

• Surgical Oncology
• Gastroenterology
• Hepatobiliary Surgery

Background:

• Pancreatoduodenal resection is a complex procedure for pancreatic head tumors.
• Defining surgical feasibility and optimizing techniques are crucial for patient outcomes.

Purpose of the Study:

• To describe experiences with 110 pancreatoduodenal resections.
• To identify critical factors influencing surgical success and patient recovery.
• To evaluate specific surgical techniques and their impact on outcomes.

Main Methods:

• Retrospective analysis of 110 pancreatoduodenal resection cases.
• Evaluation of tumor size, common bile duct width, and hepatocoledochus length as selection criteria.
• Assessment of one- vs. two-step tumor ablation techniques.
• Application of the Whipple method for reconstruction.
• Analysis of transnasal drainage for isolated Roux limb.

Main Results:

• Surgical feasibility was linked to pancreatic head tumor size (≤4 cm), common bile duct width (≤15 mm), and intact hepatocoledochus length (≥5 cm).
• The study outlines the advantages and disadvantages of one- and two-step tumor ablation.
• Preserving the gallbladder and stomach (including the pyloric sphincter) was deemed expedient.
• Postoperative lethality was reported at 7.2%.

Conclusions:

• Specific anatomical and tumor-related criteria are essential for successful pancreatoduodenal resection.
• Surgical strategies including organ preservation and specific reconstruction methods impact outcomes.
• Transnasal drainage of the isolated Roux limb may be beneficial.
• The study provides valuable insights into optimizing pancreatoduodenal resection procedures and patient management.