Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Pancreas-preserving limited duodenal resection: Minimizing morbidity without compromising oncological adequacy

  • Ajay Sharma (Department of Surgical Gastroenterology, Mahatma Gandhi University of Medical Science and Technology) ;
  • Anand Nagar (Department of Surgical Gastroenterology, Mahatma Gandhi University of Medical Science and Technology) ;
  • Peeyush Varshney (Department of Surgical Gastroenterology, All India Institute of Medical Sciences) ;
  • Maunil Tomar (Department of Surgical Gastroenterology, Mahatma Gandhi University of Medical Science and Technology) ;
  • Shashwat Sarin (Department of Surgical Gastroenterology, Mahatma Gandhi University of Medical Science and Technology) ;
  • Rajendra Prasad Choubey (Department of Surgical Gastroenterology, Mahatma Gandhi University of Medical Science and Technology) ;
  • V. K. Kapoor (Department of Surgical Gastroenterology, Mahatma Gandhi University of Medical Science and Technology)
  • Received : 2021.09.08
  • Accepted : 2021.10.25
  • Published : 2022.05.31
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Abstract

Backgrounds/Aims: Pancreaticoduodenectomy is the most common procedure for the management of duodenal pathologies. However, it is associated with substantial morbidity and a low risk of mortality. Pancreas-preserving limited duodenal resection (PPLDR) can be performed under specific scenarios. We share our experience with PPLDR and its outcome. Methods: We retrospectively analyzed a prospectively maintained database of patients undergoing limited duodenal resection in the form of wedge (sleeve) resection or segmental resection of one or more duodenal segments from March 2016 to March 2021 at a tertiary care center in North India. Results: During the study period, 10 patients (including 9 males) underwent PPLDR. Five of these 10 patients showed primary duodenal or proximal jejunal pathology, while the remaining five had duodenal pathology involving an adjacent organ tumor. Four patients underwent wedge (sleeve) resection, while the remaining six underwent segmental duodenal resection of one or more duodenal segments. Mean hospital stay was 6 days (range, 3-11 days) without 30-day mortality. Morbidity occurred in 4 patients (Grade I-II, n = 3; Grade III, n = 1). All patients were alive and disease-free at the time of last follow-up. The mean follow-up duration was 23 months (range, 2-48 months). Conclusions: PPLDR is a safe and effective alternative for pancreaticoduodenectomy when selected carefully for specific tumor types and location.

Keywords

Acknowledgement

Authors would like to acknowledge Mr. Deepak Sharma for his perennial support in obtaining and maintaining patient records.

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