title: Pancreas-sparing duodenectomy for a recurrent retroperitoneal liposarcoma: report of a case.
abstract: Pancreas-sparing duodenectomy (PSD), which allows preservation of the pancreas in its entirety, is a promising procedure for low-grade malignancies of the duodenum, the periampullary region, and the neighboring retroperitoneum. We report a case of recurrent retroperitoneal liposarcoma involving the second and third parts of the duodenum, which was extirpated using PSD, after a right hemicolectomy for tumor invasion of part of the colonic hepatic flexura. The Roux-en-Y jejunal limb was sutured to the duodenal bulb in an end-to-end fashion, and the biliary and pancreatic duct systems were reconstructed with end-to-side anastomoses, placing the jejunal limb distal to the bulbo-jejunostomy after a septoplasty to repair the adjacent pancreatic and biliary ducts. Because retroperitoneal liposarcoma has a low incidence of lymph node metastasis, pancreaticoduodenectomy may be inappropriate, especially if minimally extensive surgery can ensure organ preservation. Pancreas-sparing duodenectomy could be the most appropriate procedure for nonepithelial malignant tumors located around the duodenum distal to the pylorus, which have no involvement with the pancreatic parenchyma or periduodenal lymph nodes.
authors.affiliation: First Department of Surgery, Sapporo Medical University, S 1, W 16, Chuo-ku, Sapporo 060-8543, Japan.
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Mukaiya
authors.forename: Toshio
authors.initials: T
authors.lastname: Honma
authors.forename: Koichi
authors.initials: K
authors.lastname: Okuya
authors.forename: Emi
authors.initials: E
authors.lastname: Akizuki
authors.forename: Chikashi
authors.initials: C
authors.lastname: Kihara
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Furuhata
authors.forename: Fumitake
authors.initials: F
authors.lastname: Hata
authors.forename: Tadashi
authors.initials: T
authors.lastname: Katsuramaki
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008080:Liposarcoma / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D010180:Pancreatectomy; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D018570:Risk Assessment; D016896:Treatment Outcome