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Duodenum‐preserving head resection in chronic pancreatitis
Author(s) -
Beger Hans G.,
Imaizumi Toshihide
Publication year - 1995
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02348282
Subject(s) - medicine , duodenum , pancreatitis , stenosis , common bile duct , surgery , duodenal stenosis , pancreas , decompression , whipple procedure , pancreatic duct , bile duct , pancreatic head , stomach , gastroenterology , pancreaticoduodenectomy , radiology , resection
A duodenum‐preserving head resection was performed in 295 patients with chronic pancreatitis and an inflammatory mass in the head of the pancreas. Ninety‐four percent of patients suffered severe pain syndrome, 48% had a common bile duct stenosis, 17% a vascular obstruction in the portal vein and splenic vein branches, and 6% had a severe stenosis of the duodenum. Surgical resection of the inflammatory mass in the head of the pancreas was indicated after a medical treatment of 4.1 years (median). Subtotal resection of the head of the pancreas, including the inflammatory mass, resulted in decompression of the narrowed common bile duct segment, decompression of the pancreatic main duct, and the relief of duodenum stenosis, as well as a relief of portal hypertension. The mean hospitalization time was 13 days, frequency of re‐operation 5.8%, and hospital mortality 1.02%. Seventy‐nine percent of patients experienced long‐lasting pain relief and 11% reported a significant and long‐lasting reduction of pain; late morbidity proved to be low. In comparison to the Whipple procedure the duodenum‐preserving head resection has the advantage of preserving the stomach, duodenum and biliary tract.