Duodenopancreatectomy for pancreatic tumors — pros and cons

Authors:

Кригер А.Г.,

Кармазановский Г.Г.,

Берелавичус С.В.,

Горин Д.С.,

Калдаров А.Р.,

Пантелеев В.И.,

Двухжилов М.В.,

Дмитрий Валерьевич Калинин,

Глотов А.В.,

Зекцер В.Ю.

Журнал: Хирургия. Журнал им. Н.И. Пирогова. 2019;(12):28-36.

DOI: 10.17116/hirurgia201912128

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Abstract

Objective. To optimize surgical treatment of multiple and advanced pancreatic tumors. Material and methods. There were 852 patients with various pancreatic tumors for the period 2011 — September 2019. Duodenopancreatectomy (DPE) was performed in 18 patients. Locally advanced ductal adenocarcinoma was diagnosed in 10 patients, acinar cell carcinoma — in 1 patient, multiple neuroendocrine tumors — in 4 cases, intraductal papillary mucinous tumor — in 2 patients, multiple metastases of renal cell carcinoma — in 1 patient. This procedure was avoided in 9 patients who underwent alternative operations: pancreatoduodenectomy (PDE) with pancreatic body resection for intraductal papillary mucinous tumor — 5 cases, two-stage (2) and one-stage (1) distal pancreatectomy and PDE for multiple neuroendocrine tumors — 2 patients, simultaneous pancreatic head resection and distal pancreatectomy for multiple metastases of renal cell carcinoma — 1 patient. Results. Postoperative complications occurred in 14 patients after DPE (77.8%) and in 5 patients after alternative operations (55.5%). Alternative procedures in patients with neuroendocrine tumors, intraductal papillary mucinous tumors and metastases of renal cell carcinoma ensured radical surgical treatment. These patients did not need for insulin replacement therapy and enzyme drugs. Conclusion. Strict adherence to oncological canons and differentiated approach in patients with multiple neuroendocrine tumors, metastases of renal cell carcinoma and intraductal papillary mucinous tumors are essential to avoid DPE in some cases in favor of alternative operations.

Keywords

duodenopancreatectomy
total duodenopancreatectomy
pancreatoduodenectomy
pancreas

Дата публикации: 30.04.2020

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