Pancreas-Sparing Distal Duodenectomy for Distal Duodenal Malignancies: A Single-Center Experience

Document Type : Original Clinical

Authors

Mustapha University Hospital, Algeria

Abstract

Background:
Pancreas-sparing distal duodenectomy (PSDD) has emerged as a technically feasible and less morbid alternative to pancreatoduodenectomy (PD) for tumors of the third and fourth portions of the duodenum. This study presents a single-center experience with PSDD, emphasizing histology-adapted surgical techniques.
 
Methods:
We retrospectively reviewed six patients (4 adenocarcinomas, 2 gastrointestinal stromal tumors) who underwent PSDD between 2016 and 2023. The preoperative workup included endoscopy, endoscopic ultrasound, and a contrast-enhanced CT scan. Surgical techniques were tailored to tumor histology: lymphadenectomy with SMA-first dissection for adenocarcinomas and limited resection for GISTs.
Results :
All patients achieved R0 resection. Postoperative morbidity included delayed gastric emptying (66.6%) and diarrhea (50%), both managed conservatively. No operative mortality occurred. One patient with pT3N1 adenocarcinoma died from metastatic recurrence at 48 months. Median hospital stay was 12 days. Median lymph node yield was 12.33.
Conclusion:
PSDD is a safe and feasible procedure that may serve as an alternative to PD for malignancies of the distal duodenum.

Keywords

Main Subjects

Footnotes. Sara Salem (lecturer of internal medicine, gastroenterology, and hepatology unit), Emad Hamed (Professor of internal medicine, gastroenterology, and hepatology unit), and Amany Mohamed (Professor of family medicine and biostatistician) were peer reviewers. E- Editor: Salem Youssef Mohamed, Osama Ahmed Khalil, Amany Mohammed. Copyright ©. This open-access article is distributed under the Creative Commons Attribution License (CC BY). It may be used, distributed, or reproduced in other forums, provided the original author(s) and the copyright owner(s) are credited. The original publication in this journal must be cited according to accepted academic practice. Disclaimer: The authors' claims in this article are solely their own and do not necessarily represent their affiliated organizations or those of the publisher, the editors, or the reviewers. Any product evaluated in this article or its manufacturer's claim is not guaranteed or endorsed by the publisher. Ethics approval Ethical clearance was obtained for the conduct of this study. All participants provided informed consent to be enrolled in the study. Data and materials availability: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests: The authors declare that they have no competing interests. Funding: This study had no funding from any source. This work was conducted in accordance with the CARE guidelines. Authors' contributions: All authors contributed to data collection, analysis, and manuscript preparation. All authors read, revised, and approved the final manuscript. Acknowledgments: Not applicable.

Files

Share

How to cite

Statistics