Pancreatic head resection with segmental duodenectomy for pancreatic neoplasms.
OBJECTIVE
We have experienced 67 cases of pancreatic head resection with segmental duodenectomy (PHRSD) for benign or low-grade malignant tumor of the pancreatic head region. Here we introduce our operative technique for these 67 cases.


METHODS
Pancreatic head resection is performed with segmental duodenectomy including minor and major papilla. By conserving the right gastric artery and the gastroduodenal artery, 5-7 cm of the first portion of the duodenum is preserved with good arterial circulation. In addition, by conserving the anterior inferior pancreatoduodenal artery, the third portion and anal side or the second portion of the duodenum are preserved with good arterial circulation. Cholecystectomy is performed. The procedure is completed by resection of the pancreatic head with 3-4 cm of segmental duodenectomy including minor and major papilla. Reconstruction of the alimentary tract is performed with pancreatogastrostomy, end-to-end duodenoduodenostomy and end-to-side choledochoduodenostomy.


RESULTS
In 67 cases with diseases of the pancreatic head region, chiefly intraductal papillary mucinous neoplasms, this procedure was successfully performed without operative or hospital death. Postoperative quality of life was quite satisfactory.


CONCLUSIONS
Total resection of the pancreatic head can be performed safely and effectively by this procedure.
Nakao
Akimasa
A
Department of Surgery II, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.n nakaoaki@med.nagoya-u.ac.jp
Takeda
Shin
S
Nomoto
Shuji
S
Kanazumi
Naohito
N
Kasuya
Hideki
H
Sugimoto
Hiroyuki
H
Fujii
Tsutomu
T
Yamada
Suguru
S
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000601:surgery; D002768:Choledochostomy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome