Duodenum-preserving total pancreatic head resection by modified Takada procedure

Objective To explore the clinical application value of duodenum-preserving total pancreatic head resection by modified Takada procedure in the treatment of pancreatic head lesions. Methods The clinical data of 6 cases of modified Takada duodenum-preserving total pancreatic head resection in Zhangzhou Affilicated Hospital of Fujian Medical University and Zhangzhou Zhengxing Hospital from Sep 2013 to Sep 2014 was retrospectively analyzed. Results The mean operative time was (281.7±42.6) minutes, the mean intraoperative blood loss was (300±187) ml.The mean time to recovery to oral food-intake was (3.7±1.6) days. Average length of hospital stay after operation was (9±4.3) days.Of these cases, all preserved duodenal papilla and Vater ampulla and one-stage end-to-end anastomosis of the pancreatic duct in situ was done.Postoperative complications developed in 2 cases, one was pancreatic leakage and other one was bile leakage, all were cured conservatively.No perioperative deaths occurred. Postoperative pathology proved chronic pancreatitis in 3 cases and primary pancreatic tumors in another. 3 Follow-up time ranged from 6 to 17 months, median was 13 months.There was no case of recurrence. Conclusions The modified Takada duodenum-preserving total pancreatic head resection removes pancreatic head where the lesion lies totally.One-stage end-to-end pancreatic duct reconstruction in situ is safe, ensuring fast and uneventful recovery. Key words: Pancreatectomy; Duodenum