Case Report
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World J Gastroenterol. Nov 28, 2014; 20(44): 16786-16792
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16786
Duodenum-preserving resection and Roux-en-Y pancreatic jejunostomy in benign pancreatic head tumors
Chun-Hui Yuan, Ming Tao, Yi-Mu Jia, Jing-Wei Xiong, Tong-Lin Zhang, Dian-Rong Xiu
Chun-Hui Yuan, Ming Tao, Yi-Mu Jia, Jing-Wei Xiong, Tong-Lin Zhang, Dian-Rong Xiu, Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
Author contributions: Xiu DR and Zhang TL designed the report; Yuan CH and Tao M collected the patient’s clinical data; Jia YM and Xiong JW carried out the immunoassays; Yuan CH and Zhang TL wrote the paper.
Supported by Capital Medical Science Development Funds of China, No. 2009-3027
Correspondence to: Dian-Rong Xiu, MD, PhD, Department of General Surgery, Peking University Third Hospital, 49 North Garden Street, Haidian District, Beijing 100191, China. xiudianrong@163.com
Telephone: +86-10-82267338 Fax: +86-10-62010334
Received: February 10, 2013
Revised: April 17, 2014
Accepted: May 29, 2014
Published online: November 28, 2014
Processing time: 294 Days and 23 Hours
Abstract

This study was conducted to explore the feasibility of partial pancreatic head resection and Roux-en-Y pancreatic jejunostomy for the treatment of benign tumors of the pancreatic head (BTPH). From November 2006 to February 2009, four patients (three female and one male) with a mean age of 34.3 years (range: 21-48 years) underwent partial pancreatic head resection and Roux-en-Y pancreatic jejunostomy for the treatment of BTPH (diameters of 3.2-4.5 cm) using small incisions (5.1-7.2 cm). Preoperative symptoms include one case of repeated upper abdominal pain, one case of drowsiness and two cases with no obvious preoperative symptoms. All four surgeries were successfully performed. The mean operative time was 196.8 min (range 165-226 min), and average blood loss was 138.0 mL (range: 82-210 mL). The mean postoperative hospital stay was 7.5 d (range: 7-8 d). In one case, the main pancreatic duct was injured. Pathological examination confirmed that one patient suffered from mucinous cystadenoma, one exhibited insulinoma, and two patients had solid-pseudopapillary neoplasms. There were no deaths or complications observed during the perioperative period. All patients had no signs of recurrence of the BTPH within a follow-up period of 48-76 mo and had good quality of life without diabetes. Partial pancreatic head resection with Roux-en-Y pancreatic jejunostomy is feasible in selected patients with BTPH.

Keywords: Pancreatic benign tumor; Pancreatic head; Partial resection; Roux-en-Y pancreatic jejunostomy; Postoperative complications

Core tip: This study elucidated an innovative technique for local pancreatic head resection and Roux-en-Y pancreatic jejunostomy in four patients with benign tumors of the pancreatic head and showed that local resection of the pancreatic head in combination with Roux-en-Y pancreatic jejunostomy not only completely resected the pancreatic tumor but also retained optimal pancreatic function and reduced the incidence of pancreatic leakage.