23.10.2020 | ASO Author Reflections
ASO Author Reflections: Innovative Techniques for Laparoscopic Duodenum-Preserving Pancreatic Head Resection
verfasst von:
Jian Cheng, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 6/2021
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Excerpt
Following the invention by Hans G. Beger of the procedure of duodenum-preserving pancreatic head resection (DPPHR) combined with Roux-en-Y pancreatic–enteral reconstruction for chronic pancreatitis in 1972, a single-center 26-year experience of how DPPHR changed the natural course of the disease and affected short- and long-term clinical efficacy was analyzed and evaluated by Beger in 1999.
1 The results included low incidence of postoperative complication and mortality as well as the advantages of maintaining the endocrine and exocrine functions of the pancreas and high remission rate (91.3%) of abdominal pain. Three prospective randomized controlled studies showed that DPPHR had significantly better short-term clinical efficacy compared with pancreaticoduodenectomy, which was also a conventional surgical procedure for chronic pancreatitis. Moreover, DPPHR offered the obvious advantages of stomach, duodenum, and biliary tree preservation, high long-term quality of life, and good exocrine functions.
2 With the rapid progress in laparoscopic pancreatic surgery over the last decade, laparoscopic duodenum-preserving pancreatic head resection (LDPPHR) still remains a challenging surgery due to the requirement for complicated pancreaticojejunostomy (PJ) and ensuring sufficient blood supply to the duodenum and common bile duct (CBD) and their preservation. …