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.
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.
Authors: Helmut Witzigmann; Doris Max; Dirk Uhlmann; Felix Geissler; Reinhold Schwarz; Stephan Ludwig; Tobias Lohmann; Karel Caca; Volker Keim; Andrea Tannapfel; Johann Hauss Journal: Surgery Date: 2003-07 Impact factor: 3.982