PMID- 15650799
OWN - NLM
STAT- MEDLINE
DCOM- 20050531
LR  - 20181113
IS  - 0364-2313 (Print)
IS  - 0364-2313 (Linking)
VI  - 29
IP  - 2
DP  - 2005 Feb
TI  - New pancreas-preserving total duodenectomy technique.
PG  - 203-7
AB  - Pancreas-preserving total duodenectomy (PPTD) was first described by Chung et al. 
      in 1994. Since then, several surgeons have used PPTD to treat diseases that 
      involve the duodenum diffusely but not the head of the pancreas, mostly familial 
      adenomatous polyposis (FAP). The PPTD method has been changed in each report and 
      seems to have improved over time. We performed PPTD on three patients with 
      different diseases--one with intestinal hemorrhage due to small intestinal 
      amyloidosis; another with numerous duodenal gastrinomas in a patient with 
      multiple endocrine neoplasia type 1 (MEN-1) and Zollinger-Ellison syndrome (ZES); 
      and the third with numerous duodenal polyposis and FAP--using a new method that 
      is simpler and safer than those previously reported. When resecting the whole 
      duodenum, we performed mucosectomy of the major papillar portion and saved the 
      structure of the major papilla. After an approximately 8 mm long 
      sphincteropapillotomy, the opened major papilla was anastomosed to an incisional 
      opening of the small intestine. The orifice of the main pancreatic duct (MPD) was 
      stented by a catheter, and the MPD was kept intact under direct vision during the 
      operative procedures. The head of the pancreas was fixed with the small intestine 
      by interrupted 4-0 silk sutures. Reconstruction of the alimentary tract was 
      performed after either the Billroth I or the Billroth II method. This is the 
      first report of PPTD in which the entire MPD was preserved to simplify the 
      biliopancreatic-ductal reconstruction.
FAU - Imamura, Masayuki
AU  - Imamura M
AD  - Department of Surgery and Surgical Basic Science, Graduate School of Medicine, 
      Kyoto University and Misugikai Sato Hospital, 54 Kawaracho, Shogoin, Sakyo-ku, 
      Kyoto 606-8507, Japan. imamuram@noe.saiseikai.or.jp
FAU - Komoto, Izumi
AU  - Komoto I
FAU - Doi, Ryuichiro
AU  - Doi R
FAU - Onodera, Hisashi
AU  - Onodera H
FAU - Kobayashi, Hiroyuki
AU  - Kobayashi H
FAU - Kawai, Yasuhiro
AU  - Kawai Y
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Adenomatous Polyposis Coli/surgery
MH  - Aged
MH  - *Digestive System Surgical Procedures
MH  - Duodenal Diseases/*surgery
MH  - Duodenum/*surgery
MH  - Female
MH  - Gastrinoma/surgery
MH  - Humans
MH  - Male
EDAT- 2005/01/15 09:00
MHDA- 2005/06/01 09:00
CRDT- 2005/01/15 09:00
PHST- 2005/01/15 09:00 [pubmed]
PHST- 2005/06/01 09:00 [medline]
PHST- 2005/01/15 09:00 [entrez]
AID - 10.1007/s00268-004-7585-z [doi]
PST - ppublish
SO  - World J Surg. 2005 Feb;29(2):203-7. doi: 10.1007/s00268-004-7585-z.