title: A novel "salvage" indication to intestinal derotation procedure: reconstruction after duodenopancreatectomy.
abstract: METHODS
  Male, 77.
  
  
  METHODS
  Pancreatic tumor.
  
  
  METHODS
  Jaundice.
  
  
  METHODS
  -.
  
  
  METHODS
  Intestinal derotation procedure.
  
  
  METHODS
  General surgery.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  The purpose of the present paper is to stress the relevance for surgeons of being familiar with the procedure of intestinal derotation. This procedure is usually ignored by atlases of surgical technique and only few dedicated papers have been published since its first descriptions both in the U.S. and Europe more than 50 yrs ago.
  
  
  METHODS
  The occasion for this message has been provided by a recent application of this procedure, which has also provided a brand new indication to it. In the case which is reported in the paper the reconstruction, after the resection phase of Whipple procedure, appeared impossible. As a matter of fact, a lipomatosis of the jejunal mesentery reaching up the vasa recta made impossible to raise up the jejunum in order to perform anastomoses with the remaining pancreas and the bile duct. After a minute in which we felt lost, intestinal derotation solved the problem.
  
  
  CONCLUSIONS
  In conclusion, intestinal derotation represents a valuable technical tool, which in very selected cases may be helpful in solving otherwise insoluble surgical problems. Therefore, it seems to be a necessary part of the armamentarium of any good surgeon.
authors: Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors: Paolo
authors: P
authors: Bechi
authors: Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors: Gherardo
authors: G
authors: Maltinti
mesh_terms: D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004386:Duodenum / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D010179:Pancreas / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016879:Salvage Therapy / Q000379:methods*