Laparoscopic partial sleeve duodenectomy (PSD) for nonampullary duodenal neoplasms: Avoiding a whipple by separating the duodenum from the pancreatic head

John Andrew Stauffer, Massimo Raimondo, Timothy A. Woodward, Ross F. Goldberg, Steven P. Bowers, Horacio J. Asbun

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

OBJECTIVE: To learn the clinical outcome of patients undergoing laparoscopic partial sleeve duodenectomy (PSD) for lesions, which require sleeve resection of the duodenum. Traditionally, these lesions require en bloc excision of the head of the pancreas performed in an open fashion. METHODS: A retrospective review of medical records of patients with nonampullary large or circumferential duodenal lesions, which were not amenable to endoscopic or local resection for complete removal, was performed. Characteristics, complications, and technical details were analyzed. RESULTS: Ten patients (5 men and 5 women; mean age, 70 years) with duodenal lesions including adenoma (n = 5), adenocarcinoma (n = 2), lymphangiolipoma (n = 1), leiomyoma (n = 1), and neuroendocrine tumor (n = 1) were included. All patients underwent a laparoscopic approach with either a proximal PSD (n = 3) or distal PSD (n = 7) after separation of the duodenum from the pancreatic head. Reconstruction was carried out by a side-to-side duodenojejunostomy (n = 7), end-to-side duodenojejunostomy (n = 2), or gastrojejunostomy (n = 1). Mean length of stay was 5.6 days, and complications were 20%. CONCLUSIONS: Laparoscopic PSD seems to be a safe and easily applicable technique for treatment of duodenal lesions not involving the ampulla, which requires separation of the duodenum from the pancreas head with sleeve resection of the duodenum and subsequent reconstruction.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalPancreas
Volume42
Issue number3
DOIs
StatePublished - Apr 1 2013

Keywords

  • Adenoma
  • Duodenum
  • Pancreaticoduodenectomy
  • Whipple

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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