Duodenum-preserving pancreatic head resection in benign and low-grade malignant pancreatic tumors
Juhan Lee ; Jin Hong Lim ; Kyung Sik Kim ; Jae Bock Chung ; Seung Woo Park ; Hyun Ki Kim ; Sung Hoon Kim
Korean Journal Of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지), Vol.17(3) : 126~130, 2013
Korean Journal Of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)
Backgrounds/Aims: With development of imaging techniques, pancreatic tumors are being diagnosed more frequently.
Applying the standard surgical procedures for pancreatic head tumors, such as pancreaticoduodenectomy and pylorus-
preserving pancreaticoduodenectomy may seem too extensive for benign or low-grade malignant pancreas head
tumors. Duodenum-preserving pancreatic head resection (DPPHR) has been safely performed in patients with chronic
pancreatitis. Recently, DPPHR has been used as a limited surgical procedure to remove benign or low-grade malignant
pancreatic head lesions. This study is aimed to evaluate the results of DPPHR in benign or low-grade malignant tumors.
Methods: Between 2004 and 2012, six patients underwent DPPHR due to benign or low-grade malignant pancreas
tumor. We performed this retrospective analysis based on the medical records. Results: Five of six patients were diagnosed
as intraductal papillary mucinous neoplasms. Remaining one patient was diagnosed as solid pseudopapillary
neoplasm. The median age of patients was 60.3 (27-75) years, and the median follow-up period was 24 months. The
operation time, blood loss and length of stay were 442.5 minutes, 680 ml and 19.2 days, respectively. There was
no mortality. Five patients experienced complications including 1 delayed gastric empting, 2 bile duct strictures, 1 pancreatic
fistula and 1 duodenal stricture. No recurrence or metastasis was found during follow-up. Conclusions: In benign
and low-grade malignant lesions of pancreatic head, DPPHR could be alternative to traditional surgery. For applying
DPPHR in pancreas tumor, a thorough preoperative examination and utilization of frozen section for sufficient resection
margin are required.