Duodenum-preserving total pancreatic head resection without segment resection of the duodenum for chronic pancreatitis

Abstract

The purpose of this study was to describe a duodenum-preserving total pancreatic head resection procedure without segment resection of the duodenum for the treatment of chronic pancreatitis with an enlarged pancreatic head. Between January 1999 and December 2006, 35 patients with chronic pancreatitis were operated on by duodenum-preserving total pancreatic head resection procedure without segment resection of the duodenum. These patients were followed up to estimate the outcomes of the surgical procedure. The mortality of the surgical procedure was 0. The overall morbidity was 17%. One patient developed pancreatic fistula, three patients developed bile leakage, and no patient developed duodenal fistula. Twenty-one patients who suffered abdominal pain in preoperative stage obtained complete pain relief, the mean European Organization for Research and Treatment of Cancer QLQ-C30 pain scale decreased from 59 +/- 27 to 13 +/- 21. In the postoperative stage, the endocrine function of the patients compared equally to the preoperative stage. The modified procedure obtains acceptable postoperative outcomes and benefits on extirpation of inflammatory lesions and avoidance of the anastomosis of the residual pancreatic head and the jejunum.