Pancreas-Sparing Total Duodenectomy.
10.4174/jkss.2009.76.4.262
- Author:
Seung Eun LEE
1
;
Dae Wook HWANG
;
Chang Sup LIM
;
Jin Young JANG
;
Sun Whe KIM
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. sunkim@plaza.snu.ac.kr
- Publication Type:Case Report
- Keywords:
Pancreas;
Duodenectomy
- MeSH:
Adenoma;
Ampulla of Vater;
Duodenum;
Extremities;
Humans;
Jejunum;
Ligaments;
Pancreas;
Pancreatic Fistula;
Pylorus
- From:Journal of the Korean Surgical Society
2009;76(4):262-265
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pancreas-sparing total duodenectomy (PSTD), which allows preservation of the pancreas in its entirety is a promising procedure for benign or premalignant lesions at duodenum without invading the pancreas. We report two cases of tubular adenoma of Ampulla of Vater and a GIST of duodenum, which were resected by PSTD. The proximal duodenum was transected at 2 cm distal of pylorus and the distal end was cut in the distal portion of the Treitz ligament. The proximal jejunal limb was used for biliary-pancreatic duct systems reconstruction with end-to-side anastomosis and distal jejunum was anastomosed to duodenal bulb with an end-to-side anastomosis. Although a pancreatic fistula occurred in one patient, it was improved by conservative management. PSTD is a challenging surgical technique and requires excellent knowledge of anatomy. If performed for appropriate indications, PSTD is a useful alternative to formal pancreatoduodenecotmy and can be done safely with gastrointestinal function maintained.
