Pancreas-sparing duodenectomy: technique and indications.

OBJECTIVE: To assess the feasibility, safety, and short-term functional outcome of a pancreas-sparing duodenectomy. DESIGN: Prospective, uncontrolled study. SETTING: University hospital, Sweden. SUBJECTS: Four patients with extensive lesions in the duodenum (2 familial polyposis, 1 villous adenoma, and 1 giant multiple lipoma). RESULTS: All 4 patients had a duodenectomy with sparing of 1-1.5 cm of the duodenal bulb and reinplantation of the biliary and pancreatic ducts into the jejunum. Except for one early postoperative bile leak the operative and postoperative courses were uneventful. The functional results have been promising with unaltered alimentary function in the 3 patients who had no preoperative outlet obstruction and complete resolution of symptoms in the patient with duodenal lipomas who had chronic incomplete obstruction preoperatively. CONCLUSIONS: Although the indications for pancreas-preserving duodenectomy are limited, the procedure can be done safely with gastrointestinal function maintained.