Pancreas-preserving total duodenectomy

Area of Science:

• Surgical Oncology
• Gastroenterology
• Abdominal Surgery

Background:

• The principle of maximal resection with organ preservation guides surgical innovation.
• Classic pancreaticoduodenectomy (Whipple procedure) involves significant pancreatic resection.
• A need exists for less invasive duodenal resection techniques.

Purpose of the Study:

• To introduce and evaluate pancreas-preserving total duodenectomy as an alternative to classic pancreaticoduodenectomy.
• To highlight the technical aspects and indications for this novel procedure.
• To assess the early outcomes and feasibility of pancreas-preserving total duodenectomy.

Main Methods:

• Description of the surgical technique for total duodenectomy with pancreatic head preservation.
• Review of indications, primarily benign or premalignant duodenal mucosal conditions like familial adenomatous polyposis.
• Analysis of operative time, complexity of anastomoses, and postoperative surveillance strategies.

Main Results:

• Pancreas-preserving total duodenectomy requires meticulous surgical technique and anatomical knowledge.
• The procedure was associated with shorter operative times compared to traditional methods.
• It involves fewer and safer anastomoses, facilitating postoperative endoscopic surveillance.

Conclusions:

• Pancreas-preserving total duodenectomy is a viable and potentially superior alternative for specific duodenal pathologies.
• The technique offers advantages in terms of surgical efficiency and patient recovery.
• Encouraging long-term results support the adoption of this organ-preserving approach.