[Indications and results of pancreatic surgery preserving the duodenopancreatic region].
BACKGROUND
Surgery that preserves the duodenopancreatic region has become well-established in chronic pancreatitis (CP) and some groups have begun to use these techniques to treat benign tumors and even those with uncertain potential malignancy. However, the technical complexity of this type of intervention may be greater than that of cephalic duodenopancreatectomy and complications may be even more frequent and consequently the indications for these procedures are debated. The aim of this study was to evaluate the experience accumulated at our center over the past few years in the use of pancreatic surgery preserving the duodenopancreatic region (PS). MATERIAL AND METHODS. Between 1996 and 2006, we carried out PS in 24 patients with disease localized in the head of the pancreas. PS was defined as any of the following techniques: resection of the head of the pancreas with duodenal preservation (RHPDP), uncinatectomy (UC) and cystic tumor enucleation (EN).


RESULTS
RHPDP was performed in 20 patients (83%), UC in 1 (4%) and EN in 3 (13%). Surgery was performed for CP in 11 patients, serous cystoadenoma in 4, intraductal papillary mucinous tumor in 5 and miscellaneous injuries in the four remaining patients. Overall, the series showed 54% morbidity with no post-operative mortality. The median length of postoperative hospital stay was 11 days (7-43).


CONCLUSIONS
After analyzing the experience accumulated over the years, showing nil mortality and acceptable morbidity, we believe that the use of these 3 techniques for preserving the pancreatic parenchyma is useful when their suitability is rigorously indicated. Subsequent studies should look in depth at improving quality of life and physiological effects, depending on the technique used.
Busquets
Juli
J
Servicio de Cirugía General y Digestiva, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907 Barcelona, Spain. jbusquets@csub.scs.es
Fabregat
Juan
J
Jorba
Rosa
R
Borobia
Francisco G
FG
Valls
Carlos
C
Serrano
Teresa
T
Torras
Jaume
J
Lladó
Laura
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D004378:Duodenal Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000601:surgery*; D016879:Salvage Therapy / Q000379:methods*