title: Pancreas preserving total duodenectomy for complex duodenal injury.
abstract: BACKGROUND
  To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma.
  
  
  METHODS
  Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years) presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum). There were no complications attributable to the procedure. Both patients are well on follow up.
  
  
  CONCLUSIONS
  A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.
authors: Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. jdwsjni@hotmail.com
authors: Jai Dev
authors: JD
authors: Wig
authors: Ashwinikumar
authors: A
authors: Kudari
authors: Thakur Deen
authors: TD
authors: Yadav
authors: Rudra Prasad
authors: RP
authors: Doley
authors: Kishore Gurumoorthy Subramanya
authors: KG
authors: Bharathy
authors: Naveen
authors: N
authors: Kalra
mesh_terms: D004386:Duodenum / Q000293:injuries* / Q000601:surgery*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010179:Pancreas / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult