Pancreatic Head Resection with Segmental Duodenectomy for Intraductal Papillary Mucinous Tumors of the Pancreas

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2004 Sep 11

PMID 15358333

Citations 12

Authors

Yoshiaki Murakami

Kenichiro Uemura

Yujiro Yokoyama

Masaru Sasaki

Masahiko Morifuji

Yasuo Hayashidani

Takeshi Sudo

Taijiro Sueda

Affiliations

Soon will be listed here.

Abstract

Various modifications of organ-preserving pancreatic resections have been performed for intraductal papillary mucinous tumor (IPMT) of the pancreas. The aim of this study was to evaluate usefulness of pancreatic head resection with duodenal segmentectomy (PHRSD), which is one of the organ-preserving pancreatic resections for IPMT. Pancreatic head resection with duodenal segmentectomy was indicated for the branch duct type of IPMT. Eight patients underwent PHRSD. The mean operative time was 390 minutes, and the mean blood loss was 1270 ml. Duodenal ischemia was prevented by preserving the duodenal branches of the gastroduodenal artery and the anterior inferior pancreaticoduodenal artery. Complications occurred in four patients: one with pancreatic leak, one with choledochoduodenal anastomotic stenosis, and two with delayed gastric emptying. However, no deaths occurred. The final pathologic diagnosis was adenoma in seven patients and carcinoma in situ in one patient. Six of eight patients had an adenoma with papillary growth in the main pancreatic duct. Postoperative pancreatic endocrine and exocrine functions were satisfactory. All patients were alive without recurrent disease at a median follow-up of 30 months. Pancreatic head resection with duodenal segmentectomy appears to be a useful procedure as an organ-preserving pancreatic resection for the branch duct type of IPMT, because this procedure allows a safe and complete resection of the pancreatic head without ischemia of the common bile duct and the duodenum.

Citing Articles

Long-Term Oncologic Outcome following Duodenum-Preserving Pancreatic Head Resection for Benign Tumors, Cystic Neoplasms, and Neuroendocrine Tumors: Systematic Review and Meta-analysis.

Beger H, Mayer B, Poch B Ann Surg Oncol. 2024; 31(7):4637-4653.

PMID: 38578553 PMC: 11164799. DOI: 10.1245/s10434-024-15222-y.

Duodenum-Preserving Pancreatic Head Resection for Benign and Premalignant Tumors-a Systematic Review and Meta-analysis of Surgery-Associated Morbidity.

Beger H, Mayer B, Poch B J Gastrointest Surg. 2023; 27(11):2611-2627.

PMID: 37670106 PMC: 10661729. DOI: 10.1007/s11605-023-05789-4.

Comparison of long-term benefits of organ-preserving pancreatectomy techniques for benign or low-grade malignant tumors at the pancreatic head.

Li Y, Wu W, Zhang T, Liao Q, Zhao Y, Dai M Medicine (Baltimore). 2018; 96(51):e9420.

PMID: 29390567 PMC: 5758269. DOI: 10.1097/MD.0000000000009420.

Parenchyma-Sparing, Limited Pancreatic Head Resection for Benign Tumors and Low-Risk Periampullary Cancer--a Systematic Review.

Beger H, Mayer B, Rau B J Gastrointest Surg. 2015; 20(1):206-17.

PMID: 26525207 DOI: 10.1007/s11605-015-2981-2.

Limited surgery for benign tumours of the pancreas: a systematic review.

Beger H, Siech M, Poch B, Mayer B, Schoenberg M World J Surg. 2015; 39(6):1557-66.

PMID: 25691214 DOI: 10.1007/s00268-015-2976-x.

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