Non-Whipple Operations in the Management of Benign, Premalignant and Early Cancerous Duodenal Lesions.

Published

Journal Article

AIM: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions. PATIENTS AND METHODS: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed. RESULTS: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy. The mean follow-up was 25.8 months (range=6-54 months) and no patient was lost to follow-up. Eighteen patients had preoperative diagnosis of duodenal adenomatosis, three patients had preoperative diagnosis of duodenal adenocarcinoma, one had a bleeding polyp and two had localized inflammation. Average operative time was 145 min (range=127-168 min) for transduodenal ampullectomy and 183 min (range=173-200 min) for pancreas-preserving duodenectomy (p<0.05). The estimated blood loss for transduodenal ampullectomy was 85 vs. 125 ml for pancreas-preserving duodenectomy (p<0.05). Early postoperative complications were noted in 13 cases (54.17%). There were no postoperative (90-day) deaths observed in this series and there were no recurrences during follow-up for the patients operated on with neoplastic lesions. CONCLUSION: For carefully selected patients, transduodenal ampullectomy and pancreas-preserving duodenectomy may be used in place of the Whipple operation for benign and occasionally early-stage malignant (Tis and T1) duodenal and ampullary disease.

Full Text

Duke Authors

Cited Authors

  • Papalampros, A; Moris, D; Petrou, A; Dimitrokallis, N; Karavokyros, I; Schizas, D; Delladetsima, I; Pappas, TN; Felekouras, E

Published Date

  • March 2017

Published In

Volume / Issue

  • 37 / 3

Start / End Page

  • 1443 - 1452

PubMed ID

  • 28314316

Pubmed Central ID

  • 28314316

Electronic International Standard Serial Number (EISSN)

  • 1791-7530

Digital Object Identifier (DOI)

  • 10.21873/anticanres.11468

Language

  • eng

Conference Location

  • Greece