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Pylorus- and spleen-preserving total pancreatoduodenectomy with resection of both whole splenic vessels: feasibility and laparoscopic application to intraductal papillary mucin-producing tumors of the pancreas

Authors
 Sung Hoon Choi  ;  Ho Kyoung Hwang  ;  Chang Moo Kang  ;  Chang Ik Yoon  ;  Woo Jung Lee 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.26(7) : 2072-2077, 2012 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2012
MeSH
Abdominal Pain/etiology ; Aged ; Carcinoma, Pancreatic Ductal/surgery* ; Feasibility Studies ; Female ; Humans ; Laparoscopy/methods* ; Male ; Middle Aged ; Neoplasms, Cystic, Mucinous, and Serous/surgery* ; Organ Sparing Treatments/methods* ; Pancreatic Neoplasms/surgery* ; Pancreaticoduodenectomy/methods* ; Pylorus/surgery ; Spleen/surgery ; Treatment Outcome
Keywords
Intraductal papillary mucinous tumor ; Total pancreatectomy ; Pylorus-preserving ; Spleen-preserving
Abstract
BACKGROUND: Total pancreatectomy is recommended for intraductal papillary mucinous tumors with widespread involvement of the entire pancreas. Organ-preserving and minimally invasive surgery should be applied in benign and borderline pancreatic lesions. METHODS: Pylorus- and spleen-preserving total pancreatoduodenectomy (PpSpTPD) with segmental resection of both splenic vessels was attempted for five patients. The technique was based on the concepts of two surgical procedures: pylorus-preserving pancreatoduodenectomy and distal pancreatectomy with segmental resection of splenic vessels ("extended" Warshaw's procedure). RESULTS: Three patients underwent laparoscopic-assisted PpSpTPD and two underwent open surgery. No mortality was noted. Short-term follow-up (median, 28 months) suggested that all patients tolerated the insulin therapy and showed relatively good nutritional status. Only minimal to moderate perigastric fundal varices were noted without gastrointestinal bleeding. CONCLUSIONS: PpSpTPD with segmental resection of both splenic vessels is feasible and safe. Even a minimally invasive approach can be indicated in selected patients.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-011-2113-3
DOI
22237756
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Sung Hoon(최성훈)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91897
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