췌장보존 십이지장 전절제술

• Published in: Annals of surgical treatment and research Vol. 76; no. 4; pp. 262 - 265
• Main Authors: 이승은(Seung Eun Lee), 황대욱(Dae Wook Hwang), 임창섭(Chang Sup Lim), 장진영(Jin-Young Jang), 김선회(Sun-Whe Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.04.2009
• Subjects: 일반외과학; 췌장; 십이지장 전절제술; Duodenectomy; Pancreas
• ISSN: 2288-6575; 2288-6796

Pancreas-sparing total duodenectomy (PSTD), which allows preservation of the pancreas in its entirety is a promising procedure for benign or premalignant lesions at duodenum without invading the pancreas. We report two cases of tubular adenoma of Ampulla of Vater and a GIST of duodenum, which were resected by PSTD. The proximal duodenum was transected at 2 cm distal of pylorus and the distal end was cut in the distal portion of the Treitz ligament. The proximal jejunal limb was used for biliary-pancreatic duct systems reconstruction with end-to-side anastomosis and distal jejunum was anastomosed to duodenal bulb with an end-to-side anastomosis. Although a pancreatic fistula occurred in one patient, it was improved by conservative management. PSTD is a challenging surgical technique and requires excellent knowledge of anatomy. If performed for appropriate indications, PSTD is a useful alternative to formal pancreatoduodenecotmy and can be done safely with gastrointestinal function maintained. KCI Citation Count: 0