Pancreas-preserving duodenal resections with bile and pancreatic duct replantation for duodenal dystrophy. Two case reports.
BACKGROUND
Duodenal dystrophy is a rare disease, characterized by the chronic inflammation of the aberrant pancreatic tissue in the duodenal wall.


METHODS
Two middle-aged men were admitted with upper abdominal pain of several months duration, periodic nausea and vomiting after meals, intermittent jaundice and weight loss. A diagnosis of cystic dystrophy of the vertical part of the duodenum without chronic inflammation of the orthotopic pancreas was established in both cases by multi-detector computed tomography, magnetic resonance imaging and endosonography. Both patients were successfully treated by two modifications of pancreas-preserving duodenal resections with reimplantation of the bile and pancreatic ducts into the neoduodenum.


CONCLUSIONS
These cases are a good example of a pancreas-preserving approach to duodenal dystrophy treatment and can be an alternative to the Whipple procedure in cases of mild changes of the orthotopic gland.
Egorov
Viacheslav Ivanovich
VI
The Vishnevsky Institute of Surgery, Moscow, Russia. v.egorov61@gmail.com
Butkevich
Alexander Cezarevich
AC
Sazhin
Alexander Viacheslavovich
AV
Yashina
Nina Ivanovna
NI
Bogdanov
Sergei Nikolaievich
SN
D000328:Adult; D001652:Bile Ducts / Q000601:surgery / Q000637:transplantation*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004384:Duodenoscopy; D004386:Duodenum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010182:Pancreatic Diseases / Q000517:prevention & control; D010183:Pancreatic Ducts / Q000601:surgery / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D014463:Ultrasonography