Totally laparoscopic pancreas-sparing duodenectomy |
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Authors: | Akihiro Cho Hiroshi Yamamoto Osamu Kainuma Takumi Ota Seongjin Park Hiroo Yanagibashi Hidehito Arimitsu Atsushi Ikeda Hiroaki Souda Yoshihiro Nabeya Nobuhiro Takiguchi Matsuo Nagata |
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Institution: | Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba, 260-8717, Japan, acho@chiba-cc.jp. |
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Abstract: | Pancreas-sparing duodenectomy (PSD) is a practical surgical procedure for patients with duodenal adenoma, which is difficult to resect endoscopically. We describe how we performed a totally laparoscopic PSD to resect a duodenal adenoma in a 64-year-old woman, who had been referred for treatment of a 50-mm villous polypoid mass in the second portion of the duodenum. We performed end-to-side anastomosis between the common duct of the bile and pancreatic ducts and the jejunal limb intracorporeally following the duodenal resection. A biliary leak developed, but resolved spontaneously and the patient was discharged on postoperative day (POD) 32. The surgical margin was free of neoplastic change. Although there is limited experience and appropriate indications must await future studies, this case demonstrates that laparoscopic PSD is feasible, safe, and effective for selected patients. |
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