Pancreas-Sparing Distal Duodenectomy for Distal Duodenal Malignancies: A Single-Center Experience | ||
| African Journal of Gastroenterology and Hepatology | ||
| Volume 8, Issue 1, 2025, Pages 150-158 PDF (753.97 K) | ||
| Document Type: Original Clinical | ||
| DOI: 10.21608/ajgh.2025.391561.1082 | ||
| Authors | ||
| Redha Khalfallah* ; Walid Kebieche; Kahina Dahbia Tadrist; Abderrahim Cherfa; Kamal Bennabi; Youcef Mahmoudi; Rafik Dahdouh; Zohra Imessaoudene | ||
| Mustapha University Hospital, Algeria | ||
| Abstract | ||
| Background: Pancreas-sparing distal duodenectomy (PSDD) has emerged as a technically feasible and less morbid alternative to pancreatoduodenectomy (PD) for tumors of the third and fourth portions of the duodenum. This study presents a single-center experience with PSDD, emphasizing histology-adapted surgical techniques. Methods: We retrospectively reviewed six patients (4 adenocarcinomas, 2 gastrointestinal stromal tumors) who underwent PSDD between 2016 and 2023. The preoperative workup included endoscopy, endoscopic ultrasound, and a contrast-enhanced CT scan. Surgical techniques were tailored to tumor histology: lymphadenectomy with SMA-first dissection for adenocarcinomas and limited resection for GISTs. Results : All patients achieved R0 resection. Postoperative morbidity included delayed gastric emptying (66.6%) and diarrhea (50%), both managed conservatively. No operative mortality occurred. One patient with pT3N1 adenocarcinoma died from metastatic recurrence at 48 months. Median hospital stay was 12 days. Median lymph node yield was 12.33. Conclusion: PSDD is a safe and feasible procedure that may serve as an alternative to PD for malignancies of the distal duodenum. | ||
| Keywords | ||
| : Duodenal tumors; Pancreas-sparing surgery; GIST; Adenocarcinoma; Lymphadenectomy; Duodenum; Distal duodenum; Gastrointestinal surgery; Surgical oncology; Organ-preserving surgery | ||
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