|
|
|
| Pancreas sparing duodenectomy in the treatment of primary duodenal neoplasms and other situations with duodenal involvement |
| Juli Busquets a , ∗, Josefina Lopez-Dominguez a , Ana Gonzalez-Castillo b , Marina Vila c , Nuria Pelaez a , Lluis Secanella a , Emilio Ramos a , Juan Fabregat a |
a Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, Research Group of Hepato-biliary and Pancreatic Diseases, Institut d’Investigació Biomèdica de Bellvitge - IDIBELL, Barcelona University, L’Hospitalet de Llobregat, Barcelona 08907, Spain
b Department of General Surgery, Hospital del Mar, Barcelona 08907, Spain
c Department of General Surgery, Hospital de Mataró, Barcelona 08907, Spain
∗ Corresponding author.
E-mail address: jbusquets@bellvitgehospital.cat (J. Busquets). |
|
|
|
Abstract Background: There are no clearly defined indications for pancreas-preserving duodenectomy. The present study aimed to analyze postoperative morbidity and the outcomes of patients undergoing pancreas-preserving duodenectomy.
Methods: Patients undergoing pancreas-preserving duodenectomy from April 2008 to May 2020 were included. We divided the series according to indication: scenario 1, primary duodenal tumors; scenario 2, tumors of another origin with duodenal involvement; and scenario 3, emergency duodenectomy.
Results: We included 35 patients. Total duodenectomy was performed in 1 patient of adenomatous duodenal polyposis, limited duodenectomy in 7, and third + fourth duodenal portion resection in 27. The indications for scenario 1 were gastrointestinal stromal tumor ( n = 13), adenocarcinoma ( n = 4), neu- roendocrine tumor ( n = 3), duodenal adenoma ( n = 1), and adenomatous duodenal polyposis ( n = 1); scenario 2: retroperitoneal desmoid tumor ( n = 2), recurrence of liposarcoma ( n = 2), retroperitoneal paraganglioma ( n = 1), neuroendocrine tumor in pancreatic uncinate process ( n = 1), and duodenal infiltration due to metastatic adenopathies of a germinal tumor with digestive hemorrhage ( n = 1); and scenario 3: aortoenteric fistula ( n = 3), duodenal trauma ( n = 1), erosive duodenitis ( n = 1), and biliopancreatic limb ischemia ( n = 1). Severe complications (Clavien-Dindo ≥IIIb) developed in 14% (5/35), and postoperative mortality was 3% (1/35).
Conclusions: Pancreas-preserving duodenectomy is useful in the management of primary duodenal tu- mors, and is a technical option for some tumors with duodenal infiltration or in emergency interventions.
|
|
|
|
|
|
|
|
|
2021, Vol. 20 
