Duodenum-and bile duct-preserving pancreatic head resection / 中华消化外科杂志

ABSTRACT

Duodenum-and bile duct-preserving pancreatic head resection is rarely carried out in China due to its complexity.From September 2013 to May 2014,5 patients (1 with mass-forming pancreatitis of the head of the pancreas,2 with mucinous cystadenoma of the pancreatic duct combined with focal cancerous,2 with chronic pancreatitis and pancreatic duct stones) received duodenum-and bile duct-preserving pancreatic head resection at the Zhangzhou Zhengxing Hospital.The lesions of the 5 patients were resected by the Takada method and then the pancreatic duct was reconstructed in situ.One patient received T-tube drainage of the bile duct.The operation time was 210-330 minutes,and the mean volume of intraoperative blood loss was 300 mL (range,100-500 mL).The stones of 2 patients were antler-shaped,and the other 3 patients were with tumor.No patients died intraoperatively.One patient was complicated by pancreatic leakage and 1 by bile leakage after the operation,respectively,and they were cured by non-surgical treatment.Patients were followed up for 3-11 months,and no abnormal glucose metabolism,common bile duct stricture,chronic indigestion and tumor recurrence occurred.The Takada method is safe and effective for the treatment of mass-forming pancreatitis of the head of the pancreas,benign lesions of the head of the pancreas and low-grade malignant tumor of the head of the pancreas.