Laparoscopic pancreas-sparing duodenectomy

Yorihiko Muto, MD, Akihiro Cho, MD, Hiroshi Yamamoto, MD, Osamu Kainuma, MD, Hidehito Arimitsu, MD, Atsushi Ikeda, MD, Hiroaki Souda, MD, Yoshihiro Nabeya, MD, Nobuhiro Takiguchi, MD, Matsuo Nagata, MD

Division of Gastroenterological Surgery, Chiba Cancer Center Hospital

Background: Although pancreas-sparing duodenectomy (PSD) is an attractive surgical procedure for patients with disease of the duodenum without pancreatic involvement, the surgical technique is challenging due to the close anatomical relationship between the pancreas and the duodenum.
Methods: Three patients with duodenal tumor without pancreatic involvement underwent laparoscopic PSD.
Surgical technique: In two patients, laparoscopic pancreas-sparing subtotal duodenectomy was performed. End-to-side anastomosis between the common duct of the bile and pancreatic ducts and the jejunal limb was performed intracorporeally following the duodenal resection. In the remaining patient, laparoscopic pancreas-sparing infra-ampullary duodenectomy was performed. Side-to-side anastomosis between the duodenal second portion and the jejunal limb was performed intracorporeally.
Results: In all patients, laparoscopic PSD could be successfully performed, as planned. In all three patients, the surgical margin was free of neoplastic change.
Conclusions: Laparoscopic PSD is minimally invasive, safe and feasible in selected patients with disease of the duodenum without pancreatic involvement.
Conflict of Interest: We have no conflicts of interest or financial ties to disclose.

Session: Podium Presentation

Program Number: V028