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Duodenum-Preserving Pancreatic Head Resection

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The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases

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Abstract

Duodenum-preserving pancreatic head resection (DPPHR) remains a rare procedure even for high volume centers since its clinical implementation in 1979. Reports on this surgery are scattered and present mostly as sporadic systematic reviews and case reports/case series. Terminology for those procedures varies among authors. Present chapter aims to pool current knowledge and give an idea of anatomical and surgical fundamentals of DPPHR. Latter one needs meticulous knowledge of vascular anatomy of pancreatic head and adjacent organs and might become technically more challenging when compared to pancreaticoduodenectomy. Postoperative complication rate and location of the lesion are other contributing factors to limited use of DPPHR. Limited pancreatic resection is useful mostly for benign focal pancreatic lesions and chronic pancreatitis. Exposure of main pancreatic duct and/or common bile duct and their subsequent management require large experience in hepatopancreatobiliary surgery that feels to be never enough. Author is hoping to expand the knowledge of the reader on DPPHR and promote organ-sparing technique for benign lesions just like it has become in regard to liver surgery of last decade. Any further comments and suggestions will be appreciated.

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References

  1. Beger HG, Witte C, Krautzberger W, et al. Erfahrung mit einer das Duodenum erhaltenden Pankreaskopfresektion bei chronischer Pankreatitis. Chirurg. 1980;51:303–7.

    CAS  PubMed  Google Scholar 

  2. Beger HG, Siech M, Poch B, Mayer B, Schoenberg MH. Limited surgery for benign tumours of the pancreas: a systematic review. World J Surg. 2015;39(6):1557–66.

    Article  CAS  Google Scholar 

  3. Imaizumi T, Hanyu F, Suzuki M, et al. A new procedure: duodenumpreserving total resection of the head of the pancreas with pancreaticocholedocho-duodenostomy. J Bil Tract Pancreas. 1990;11:621–6. (In Japanese)

    Google Scholar 

  4. Nakao A. Pancreatic head resection with segmental duodenectomy and preservation of the gastroduodenal artery. Hepato-Gastroenterology. 1998;45(20):533–5.

    CAS  PubMed  Google Scholar 

  5. Büchler MW, Friess H, Müller MW, Beger HG. Die duodenumerhaltende Pankreaskopfresektion: Eine neue Standardoperation bei chronischer Pankreatitis [Duodenum preserving resection of the head of the pancreas: a new standard operation in chronic pancreatitis]. Langenbecks Arch Chir Suppl Kongressbd. 1997;114:1081–3.

    PubMed  Google Scholar 

  6. Zhao Y, Zhang J, Lan Z, et al. Duodenum-preserving resection of the pancreatic head versus pancreaticoduodenectomy for treatment of chronic pancreatitis with enlargement of the pancreatic head: systematic review and meta-analysis. Biomed Res Int. 2017;2017:3565438.

    PubMed  PubMed Central  Google Scholar 

  7. Beger HG, Mayer B, Poch B. Parenchyma-sparing, local pancreatic head resection for premalignant and low-malignant neoplasms - a systematic review and meta-analysis. Am J Surg. 2018;216(6):1182–91.

    Article  Google Scholar 

  8. Takaori K, Tanigawa N. Laparoscopic pancreatic resection: the past, present, and future. Surg Today. 2007;37:535–45.

    Article  Google Scholar 

  9. Peng CH, Shen BY, Deng XX, Zhan Q, Han B, Li HW. Early experience for the robotic duodenum-preserving pancreatic head resection. World J Surg. 2012;36(5):1136–41.

    Article  Google Scholar 

  10. Jiang Y, Jin JB, Zhan Q, Deng XX, Peng CH, Shen BY. Robot-assisted duodenum-preserving pancreatic head resection with pancreaticogastrostomy for benign or premalignant pancreatic head lesions: a single-centre experience. Int J Med Robot. 2018;14(4):e1903.

    Article  Google Scholar 

  11. von Haller A. Elementa physiologiae corporis humani, Tome VI. Societatistipographicae, Bemae; 1764. pp. 431–432.

    Google Scholar 

  12. Falconer CW, Griffiths E. The anatomy of the blood-vessels in the region of the pancreas. Br J Surg. 1950;37(147):334–44.

    Article  CAS  Google Scholar 

  13. Bertelli E, Di Gregorio F, Bertelli L, Mosca S. The arterial blood supply of the pancreas: a review. I. The superior pancreaticoduodenal and the anterior superior pancreaticoduodenal arteries. An anatomical and radiological study. Surg Radiol Anat. 1995;17(2):97–3.

    Article  CAS  Google Scholar 

  14. Bertelli E, Di Gregorio F, Bertelli L, Civeli L, Mosca S. The arterial blood supply of the pancreas: a review. II. The posterior superior pancreaticoduodenal artery. An anatomical and radiological study. Surg Radiol Anat. 1996;18(1):1–9.

    Article  CAS  Google Scholar 

  15. Bertelli E, Di Gregorio F, Bertelli L, Civeli L, Mosca S. The arterial blood supply of the pancreas: a review. III. The inferior pancreaticoduodenal artery. An anatomical review and a radiological study. Surg Radiol Anat. 1996;18(2):67–74.

    Article  CAS  Google Scholar 

  16. Bertelli E, Di Gregorio F, Bertelli L, Orazioli D, Bastianini A. The arterial blood supply of the pancreas: a review. IV. The anterior inferior and posterior pancreaticoduodenal aa., and minor sources of blood supply for the head of the pancreas. An anatomical review and radiologic study. Surg Radiol Anat. 1997;19(4):203–12.

    CAS  PubMed  Google Scholar 

  17. Bertelli E, Di Gregorio F, Mosca S, et al. The arterial blood supply of the pancreas: a review. V. The dorsal pancreatic artery. Surg Radiol Anat. 1998;20:445–52.

    Article  CAS  Google Scholar 

  18. Furukawa H, Iwata R, Moriyama N, Kosuge T. Blood supply to the pancreatic head, bile duct, and duodenum: evaluation by computed tomography during arteriography. Arch Surg. 1999;134(10):1086–90.

    Article  CAS  Google Scholar 

  19. Hirata K, Mukaiya M, Kimura M, et al. The anatomy of the parapancreaticoduodenal vessels and the introduction of a new pylorus-preserving pancreatoduodenectomy with increased vessel preservation. J Hep Bil Pancr Surg. 1994;1:335–41.

    Article  Google Scholar 

  20. Kimura W, Nagai H. Study of surgical anatomy for duodenum-preserving resection of the head of the pancreas. Ann Surg. 1995;221(4):359–63.

    Article  CAS  Google Scholar 

  21. Imaizumi T, Hanyu F, Suzuki M. A new procedure for duodenum-preserving total resection of the head of the pancreas with pancreaticocholedochoduodenostomy. In: Beger HG, Büchler M, Malfertheiner P, editors. Standards in pancreatic surgery. Berlin, Heidelberg: Springer; 1993.

    Google Scholar 

  22. Takada T, Yasuda H, Uchiyama K, Hasegawa H. Duodenum-preserving pancreatoduodenostomy. A new technique for complete excision of the head of the pancreas with preservation of biliary and alimentary integrity. Hepato-Gastroenterology. 1993;40(4):356–9.

    CAS  PubMed  Google Scholar 

  23. Kim SW, Kim KH, Jang JY, Park S, Park YH. Practical guidelines for the preservation of the pancreaticoduodenal arteries during duodenum-preserving resection of the head of the pancreas: clinical experience and a study using resected specimens from pancreaticoduodenectomy. Hepato-Gastroenterology. 2001;48(37):264–9.

    CAS  PubMed  Google Scholar 

  24. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg. 1995;222(4):580–92.

    Article  CAS  Google Scholar 

  25. Büchler M, Friess H, Jseumann R, Bittner R, Beger HG. Duodenum-preserving resection of the head of the pancreas: the Ulm experience. In: Beger HG, Büchler M, Malfertheiner P, editors. Standards in pancreatic surgery. Berlin, Heidelberg: Springer; 1993.

    Google Scholar 

  26. Gloor B, Friess H, Uhl W, Büchler MW. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg. 2001;18(1):21–5.

    Article  CAS  Google Scholar 

  27. Beger HG, Mayer B, Rau BM. Parenchyma-sparing, limited pancreatic head resection for benign tumors and low-risk periampullary cancer--a systematic review. J Gastrointest Surg. 2016;20(1):206–17.

    Article  Google Scholar 

  28. Andreasi V, Partelli S, Capurso G, et al. Long-term pancreatic functional impairment after surgery for neuroendocrine neoplasms. J Clin Med. 2019;8(10):1611.

    Article  Google Scholar 

  29. Büchler MW, Friess H, Müller MW, Wheatley AM, Beger HG. Randomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis. Am J Surg. 1995;169(1):65–70.

    Article  Google Scholar 

  30. Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet. 2017;390(10099):1027–37.

    Article  Google Scholar 

  31. Witzigmann H, Max D, Uhlmann D, et al. Quality of life in chronic pancreatitis: a prospective trial comparing classical whipple procedure and duodenum-preserving pancreatic head resection. J Gastrointest Surg. 2002;6:173–80.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. International Association of Surgeons, Gastroenterologists and Oncologists, Kyoto, Japan

    Elena Usova

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  1. Elena Usova
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Editor information

Editors and Affiliations

  1. Emeritus Professor, The University of Tokyo, Tokyo, Japan

    Masatoshi Makuuchi

  2. National Center for Global Health and Medicine, The University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

  3. “Dan Setlacec” Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Irinel Popescu

  4. Emeritus Professor University Paris Cité, Paris, France

    Jacques Belghiti

  5. Department of Surgery, Seoul National University College of Medicine Seoul National University Bundang Hospital, Seoul, Korea (Republic of)

    Ho-Seong Han

  6. Nagahama City Hospital Network, Shiga, Japan

    Kyoichi Takaori

  7. Massachusetts General Hospital, Harvard Medical School, Boston, USA

    Dan G. Duda

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Usova, E. (2022). Duodenum-Preserving Pancreatic Head Resection. In: Makuuchi, M., et al. The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-0063-1_44

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  • DOI: https://doi.org/10.1007/978-981-19-0063-1_44

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-0062-4

  • Online ISBN: 978-981-19-0063-1

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