Duodenum-preserving total pancreatic head resection without segment resection of the duodenum for chronic pancreatitis

Langenbecks Arch Surg. 2009 May;394(3):563-8. doi: 10.1007/s00423-008-0428-x. Epub 2008 Oct 21.

Abstract

Purpose: The purpose of this study was to describe a duodenum-preserving total pancreatic head resection procedure without segment resection of the duodenum for the treatment of chronic pancreatitis with an enlarged pancreatic head.

Materials and methods: Between January 1999 and December 2006, 35 patients with chronic pancreatitis were operated on by duodenum-preserving total pancreatic head resection procedure without segment resection of the duodenum. These patients were followed up to estimate the outcomes of the surgical procedure.

Results: The mortality of the surgical procedure was 0. The overall morbidity was 17%. One patient developed pancreatic fistula, three patients developed bile leakage, and no patient developed duodenal fistula. Twenty-one patients who suffered abdominal pain in preoperative stage obtained complete pain relief, the mean European Organization for Research and Treatment of Cancer QLQ-C30 pain scale decreased from 59 +/- 27 to 13 +/- 21. In the postoperative stage, the endocrine function of the patients compared equally to the preoperative stage.

Conclusion: The modified procedure obtains acceptable postoperative outcomes and benefits on extirpation of inflammatory lesions and avoidance of the anastomosis of the residual pancreatic head and the jejunum.

MeSH terms

  • Abdominal Pain / surgery
  • Adolescent
  • Adult
  • Duodenum / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pancreatectomy / methods*
  • Pancreatitis, Chronic / surgery*
  • Quality of Life
  • Treatment Outcome