Open AccessPancreas-Preserving Total Duodenectomy: A Systematic Review
Author(s) -
Miguel Cantalejo-Díaz,
José Manuel Ramia-Ángel,
Ana Palomares-Cano,
Mario SerradillaMartín
Publication year - 2021
Publication title -
digestive surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.762
H-Index - 69
eISSN - 1421-9983
pISSN - 0253-4886
DOI - 10.1159/000515718
Subject(s) - medicine , cochrane library , surgery , pancreas , gastroenterology , systematic review , mortality rate , general surgery , meta analysis , medline , political science , law
Background: The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. Summary: A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo <IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was >97.8%. Key Messages: PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.