Resección conservadora de la región duodenopancreática en el tratamiento del tumor papilar mucinoso intraductal

Duodenum‐preserving versus pylorus‐preserving pancreatic head resection for benign and premalignant lesions

“…Our complication rate after DPPHR was quite high (81.5%) when compared to our complication rate after PPPD (40.5%), but the difference was not statistically significant (Table 3). The complication rate reported by other authors after DPPHR was 32.7% (36/110, range 0–100%) [2, 12, 13, , , , 45]. Such a striking difference in the complication rate may be due to only successful cases being reported [24, 26, 28, 32, 37, 43], to retrospective reporting [2, 12, 13, 25, 30, 31, 36, 38, 41, 45], and to the excellent results of some Japanese series [38, 45].…”

“…Various alternative surgical options have been proposed during the past two decades for the management of such benign or borderline lesions of the pancreatic head . Among them, DPPHR was the more frequently used procedure, although only 132 patients are reported in the English‐language literature [2, 12, 13, ].…”

“…Such a striking difference in the complication rate may be due to only successful cases being reported [24, 26, 28, 32, 37, 43], to retrospective reporting [2, 12, 13, 25, 30, 31, 36, 38, 41, 45], and to the excellent results of some Japanese series [38, 45]. A 100% complication rate was reported by some authors [27, 29, 35, 39, 42]. The complication rate by type of DPPHR (Fig.…”

“…The complication rate by type of DPPHR (Fig. 1) 14] for completely documented patients, our patients included, was 46.2% for 13 type‐1 [24, 29, 32, 35, 37, 41, ours], 57.4% for 47 type‐2 [27, 29, 39, 45, ours], and only 32.4% for 74 type‐3 DPPHR [2, 13, 25, 26, , 33, 36, 38, 42, 43, ours] ( χ 2 = 24.256, P < 0.0001). Type‐3 DPPHR was reported mainly by Japanese authors [2, 13, 25, 26, , 33, 38, 43] with a long, scrupulous dissection to preserve the vascularization of the duodenum and of the bile duct.…”

Organ-preserving surgery for benign lesions and low-grade malignancies of the pancreatic head: A matched case-control study

“…Delayed gastric emptying is a clinical scenario extensively studied following PD; however, some authors suggest that PS can be accompanied by DGE. 13,18,22 In fact, duodenal ischemia is one of the main concerns in DPPHR. According to some investigators, movement of the duodenum-pancreas or Kocher's maneuver could underlie postoperative morbidity, [23][24][25][26] which is probably related to cutting the retroperitoneal blood vessels with consequent duodenal ischemia.…”