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KMID : 0371320090760040262
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Journal of the Korean Surgical Society
2009 Volume.76 No. 4 p.262 ~ p.265
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Pancreas-Sparing Total Duodenectomy
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Lee Seung-Eun
Hwang Dae-Wook
Lim Chang-Sup
Jang Jin-Young
Kim Sun-Whe
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Abstract
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Pancreas-sparing total duodenectomy (PSTD), which allows preservation of the pancreas in its entirety is a promising procedure for benign or premalignant lesions at duodenum without invading the pancreas. We report two cases of tubular adenoma of Ampulla of Vater and a GIST of duodenum, which were resected by PSTD. The proximal duodenum was transected at 2 cm distal of pylorus and the distal end was cut in the distal portion of the Treitz ligament. The proximal jejunal limb was used for biliary-pancreatic duct systems reconstruction with end-to-side anastomosis and distal jejunum was anastomosed to duodenal bulb with an end-to-side anastomosis. Although a pancreatic fistula occurred in one patient, it was improved by conservative management. PSTD is a challenging surgical technique and requires excellent knowledge of anatomy. If performed for appropriate indications, PSTD is a useful alternative to formal pancreatoduodenecotmy and can be done safely with gastrointestinal function maintained.
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KEYWORD
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Pancreas, Duodenectomy
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