Abstract
Background
Duodenum-preserving total pancreatic head resection (DPPHRt) is an accepted alternative surgical procedure for benign or low-grade malignant tumors of the pancreatic head by preserving the duodenum with its intact blood supply from the pancreatic duodenal arterial arcade. This study describes our experience in laparoscopic DPPHRt (LDPPHRt). To our knowledge, this is the first description of this novel minimally invasive operation.
Methods
From August 2016 to May 2017, all consecutive patients who underwent LDPPHRt for pancreatic head lesions at the HPB Surgery Department, Sun Yat-Sen Memorial Hospital in Guangzhou, China were enrolled into this retrospective study.
Results
There were ten women and two men. The average age was 37.3 years (range 8–61 years). The average diameter of the pancreatic head lesions on pre-operative CT/MR was 3.7 cm (range 2–4.8 cm). All the LDPPHRt procedures were performed successfully. There was no peri-operative death. The average operative time was 272.5 min (range 210–320 min). The average blood loss was 215 ml (range 50–450 ml). Post-operative complications included pancreatic fistula grade B (two patients, or 16.7%) and biliary fistula (two patients, or 16.7%). All the complications responded well to conservative treatment. The mean post-operative hospital stay was 11.5 days (range 6–25 days).
Conclusions
LDPPHRt provided a minimally invasive approach with good organ-preservation for benign or low-grade malignant tumors of the pancreatic head. The long-term oncological outcomes, and the exocrine and endocrine pancreatic functions after this operation require further studies.
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Funding
This study is supported by Natural Science Foundation of China (81672420, 81672419, 81572398 and 81702406).
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Drs. Jun Cao, Guo-lin Li, Jin-xing Wei, Wei-Bang Yang, Chang-zhen Shang, Ya-jin Chen, Wan Yee Lau and Jun Min have no conflicts of interest or financial ties to disclose.
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Cao, J., Li, Gl., Wei, Jx. et al. Laparoscopic duodenum-preserving total pancreatic head resection: a novel surgical approach for benign or low-grade malignant tumors. Surg Endosc 33, 633–638 (2019). https://doi.org/10.1007/s00464-018-6488-2
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DOI: https://doi.org/10.1007/s00464-018-6488-2