Clinical analysis of improved duodenum-preserving total pancreatic head resection

Objective To summarize the experience of improved duodenum-preserving total pancreatic head resection for pancreatic head benign or low-grade malignant diseases.Methods Ten patients treated by improved DPTPHR admitted from June 2005 to May 2009 were reviewed retrospectively.Results Three cases were male and seven cases were female,the average age was 52 years old.All the patients underwent DPTPHR and the operation time was 340 minutes while the quantity of blood loss was 485 mL on average.The postoperative diagnosis included intraductal papillary mucinous neoplasm,solid-pseudopapillary neoplasm,insulinoma and arteriovenous malformation,one case for each;there were 2 cases of serous cystadenoma,2 cases of neuroendocrine tumor and 2 cases of chronic pancreatitis,separately.In the whole group,infection complicated by bleeding took place in 1 case,pancreatic fistula in 4 and repeated vomiting in one.No biliary fistula or duodenal ischemia occurred.In a follow-up period of 8-56 months,there was no operative mortality or tumor recurrence.Conclusions Improved DPTPHR is a safe type of operation for benign or low-grade malignant diseases located in the pancreatic head.