Clinical application and progress of duodenum-preserving pancreatic head resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Yonghui , CHENG Kun ,  CHEN Qilong

Digestive and Vascular Center, Department of Pancreatic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;

Corresponding author：

CHEN Qilong, Email: chenqilong651003@sohu.com

Keywords：

chronic pancreatitis; pancreatic tumor; pancreaticoduodenectomy; duodenum-preserving pancreatic head resection

DOI：

10.7507/1007-9424.201903019

Video：

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Objective To summarize of clinical application and progress of duodenum-preserving pancreatic head resection (DPPHR).Method The relevant literatures published recently at domestic and abroad about the clinical application and progress of DPPHR were collected and reviewed.Results For the benign lesions, low-grade malignancies and borderline tumors of the head of pancreas, the DPPHR could achieve the same expected therapeutic effect as the classical pancreatoduodenectomy. The DPPHR could reserve the continuity of stomach and duodenum while resecting lesions and improve the symptoms of patients, reduce the reconstruction of digestive tract and the resection of pancreas and surrounding tissues as much as possible, and retain the pancreas-intestinal axis, which was more in line with the physiology of human beings.Conclusions At present, DPPHR is worthy of further development and promotion in department of pancreas surgery, but current studies only focus on occurrence of short-term complications after operation. Because patients with benign diseases of pancreatic head have better prognosis and longer survival time after operation, we should pay attention to the long-term complications such as diarrhea, anemia and reflux cholangitis. More clinical studies need in future to be demonstrated superiority of DPPHR in clinical efficacy and to evaluate occurrence of long-term complications and their impact on quality of life of patients with DPPHR by comprehensive analysis of multiple evaluation indicators.

Citation： SUN Yonghui, CHENG Kun, CHEN Qilong. Clinical application and progress of duodenum-preserving pancreatic head resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1259-1264. doi: 10.7507/1007-9424.201903019 Copy

1.	Hu LH, Ji JT, Li ZS. Potential application of miRNAs as diagnostic and therapeutic tools in chronic pancreatitis. J Cell Mol Med, 2015, 19(9): 2049-2057.
2.	Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
3.	Laramée P, Wonderling D, Cahen DL, et al. Trial-based cost-effectiveness analysis comparing surgical and endoscopic drainage in patients with obstructive chronic pancreatitis. BMJ Open, 2013, 3(9): e003676.
4.	Ahmed Ali U, Pahlplatz JM, Nealon WH, et al. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis. Cochrane Database Syst Rev, 2015, (3): CD007884.
5.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
6.	Beger HG, Poch B, Vasilescu C. Benign cystic neoplasm and endocrine tumours of the pancreas—when and how to operate—an overview. Int J Surg, 2014, 12(6): 606-614.
7.	Beger HG, Krautzberger W, Bittner R, et al. Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 1985, 97(4): 467-473.
8.	Gloor B, Friess H, Uhl W, et al. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg, 2001, 18(1): 21-25.
9.	Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas, 1987, 2(6): 701-707.
10.	Takada T, Yasuda H, Uchiyama K, et al. Duodenum-preserving pancreatoduodenostomy. A new technique for complete excision of the head of the pancreas with preservation of biliary and alimentary integrity. Hepatogastroenterology, 1993, 40(4): 356-359.
11.	Takada T, Yasuda H, Uchiyama K, et al. Complete duodenum-preserving resection of the head of the pancreas with preservation of the biliary tract. J Hepato-Biliary-Pancreatic Surg, 1995, 2(1): 32-37.
12.	李建国, 王渊全, 陈谭根, 等. 保留十二指肠和胆管的胰头全切除术. 中华消化外科杂志, 2014, 13(11): 898-901.
13.	Imaizumi T, Hanyu F, Suzuki M. A new procedure for duodenum-preserving total resection of the head of the pancreas with pancreaticocholedochoduodenostomy//Beger HG, Büchler M, Malfertheiner P. Standards in pancreatic surgery. Springer-Verlag Berlin Heidelberg, 1993: 464-470.
14.	Hatori T, Imaizumi T, Harada N, et al. Appraisal of the Imaizumi modification of the Beger procedure: the TWMU experience. J Hepatobiliary Pancreat Sci, 2010, 17(6): 752-757.
15.	Gupte AR, Forsmark CE. Chronic pancreatitis. Curr Opin Gastroenterol, 2014, 30(5): 500-505.
16.	Braganza JM, Lee SH, McCloy RF, et al. Chronic pancreatitis. Lancet, 2011, 377(9772): 1184-1197.
17.	Bachmann K, Tomkoetter L, Kutup A, et al. Is the Whipple procedure harmful for long-term outcome in treatment of chronic pancreatitis? 15-years follow-up comparing the outcome after pylorus-preserving pancreatoduodenectomy and Frey procedure in chronic pancreatitis. Ann Surg, 2013, 258(5): 815-821.
18.	Beger HG, Mayer B, Poch B. Duodenum-preserving pancreatic head resection : A local parenchyma-sparing treatment of benign and premalignant tumors of the pancreatic head. Chirurg, 2019 Mar 21. doi: 10.1007/s00104-019-0942-0.
19.	Beger HG, Nakao A, Mayer B, et al. Duodenum-preserving total and partial pancreatic head resection for benign tumors—systematic review and meta-analysis. Pancreatology, 2015, 15(2): 167-178.
20.	Fujii T, Kanda M, Kodera Y, et al. Comparison of pancreatic head resection with segmental duodenectomy and pylorus-preserving pancreatoduodenectomy for benign and low-grade malignant neoplasms of the pancreatic head. Pancreas, 2011, 40(8): 1258-1263.
21.	Gong DJ, Zhang JM, Mao GJ, et al. Duodenum-preserving pancreatic head resection vs. pancreatoduodenectomy for benign lesions and low-grade malignancies of the pancreatic head. Hepatogastroenterology, 2013, 60(121): 19-22.
22.	Skórzewska M, Romanowicz T, Mielko J, et al. Frey operation for chronic pancreatitis associated with pancreas divisum: case report and review of the literature. Prz Gastroenterol, 2014, 9(3): 175-178.
23.	Snajdauf J, Petru O, Nahlovsky J, et al. Pancreas divisum in children and duodenum-preserving resection of the pancreatic head. Eur J Pediatr Surg, 2018, 28(3): 250-254.
24.	Tsuchikawa T, Hirano S, Tanaka E, et al. Modified duodenum-preserving pancreas head resection for low-grade malignant lesion in the pancreatic head. Pancreatology, 2013, 13(2): 170-174.
25.	刘翔琪, 董岿然, 柳龚堡, 等. 保留十二指肠胰头肿块切除术在儿童胰头肿瘤治疗中的应用. 中华小儿外科杂志, 2017, 38(2): 103-106.
26.	覃虹, 董明, 周建平, 等. 保留器官功能胰腺切除术 76 例报告. 中国实用外科杂志, 2012, 32(9): 778-780.
27.	Zhang C, Liu F, Chang H, et al. Less aggressive surgical procedure for treatment of solid pseudopapillary tumor: Limited experience from a single institute. PLoS One, 2015, 10(11): e0143452.
28.	Zhao X, Cui N, Wang X, et al. Surgical strategies in the treatment of chronic pancreatitis: An updated systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore), 2017, 96(9): e6220.
29.	Beger HG, Mayer B. Duodenum-preserving pancreatic head resection in chronic pancreatitis : Limitations of the Heidelberg multicenter ChroPac study. Chirurg, 2018, 89(5): 392-396.
30.	刘续宝. 慢性胰腺炎的胰头炎性包块的外科治疗. 中国普外基础与临床杂志, 2013, 20(2): 121-123.
31.	张太平, 曹喆, 赵玉沛. 慢性胰腺炎合并胰头肿块的外科治疗策略. 中国普外基础与临床杂志, 2016, 23(6): 644-646.
32.	Klaiber U, Alldinger I, Probst P, et al. Duodenum-preserving pancreatic head resection: 10-year follow-up of a randomized controlled trial comparing the Beger procedure with the Berne modification. Surgery, 2016, 160(1): 127-135.
33.	Snajdauf J, Rygl M, Petru O, et al. Indications and outcomes of duodenum-preserving resection of the pancreatic head in children. Pediatr Surg Int, 2019, 35(4): 449-455.
34.	Beger HG, Poch B, Mayer B, et al. New onset of diabetes and pancreatic exocrine insufficiency after pancreaticoduodenectomy for benign and malignant tumors: a systematic review and meta-analysis of long-term results. Ann Surg, 2018, 267(2): 259-270.

1. Hu LH, Ji JT, Li ZS. Potential application of miRNAs as diagnostic and therapeutic tools in chronic pancreatitis. J Cell Mol Med, 2015, 19(9): 2049-2057.
2. Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
3. Laramée P, Wonderling D, Cahen DL, et al. Trial-based cost-effectiveness analysis comparing surgical and endoscopic drainage in patients with obstructive chronic pancreatitis. BMJ Open, 2013, 3(9): e003676.
4. Ahmed Ali U, Pahlplatz JM, Nealon WH, et al. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis. Cochrane Database Syst Rev, 2015, (3): CD007884.
5. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
6. Beger HG, Poch B, Vasilescu C. Benign cystic neoplasm and endocrine tumours of the pancreas—when and how to operate—an overview. Int J Surg, 2014, 12(6): 606-614.
7. Beger HG, Krautzberger W, Bittner R, et al. Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 1985, 97(4): 467-473.
8. Gloor B, Friess H, Uhl W, et al. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg, 2001, 18(1): 21-25.
9. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas, 1987, 2(6): 701-707.
10. Takada T, Yasuda H, Uchiyama K, et al. Duodenum-preserving pancreatoduodenostomy. A new technique for complete excision of the head of the pancreas with preservation of biliary and alimentary integrity. Hepatogastroenterology, 1993, 40(4): 356-359.
11. Takada T, Yasuda H, Uchiyama K, et al. Complete duodenum-preserving resection of the head of the pancreas with preservation of the biliary tract. J Hepato-Biliary-Pancreatic Surg, 1995, 2(1): 32-37.
12. 李建国, 王渊全, 陈谭根, 等. 保留十二指肠和胆管的胰头全切除术. 中华消化外科杂志, 2014, 13(11): 898-901.
13. Imaizumi T, Hanyu F, Suzuki M. A new procedure for duodenum-preserving total resection of the head of the pancreas with pancreaticocholedochoduodenostomy//Beger HG, Büchler M, Malfertheiner P. Standards in pancreatic surgery. Springer-Verlag Berlin Heidelberg, 1993: 464-470.
14. Hatori T, Imaizumi T, Harada N, et al. Appraisal of the Imaizumi modification of the Beger procedure: the TWMU experience. J Hepatobiliary Pancreat Sci, 2010, 17(6): 752-757.
15. Gupte AR, Forsmark CE. Chronic pancreatitis. Curr Opin Gastroenterol, 2014, 30(5): 500-505.
16. Braganza JM, Lee SH, McCloy RF, et al. Chronic pancreatitis. Lancet, 2011, 377(9772): 1184-1197.
17. Bachmann K, Tomkoetter L, Kutup A, et al. Is the Whipple procedure harmful for long-term outcome in treatment of chronic pancreatitis? 15-years follow-up comparing the outcome after pylorus-preserving pancreatoduodenectomy and Frey procedure in chronic pancreatitis. Ann Surg, 2013, 258(5): 815-821.
18. Beger HG, Mayer B, Poch B. Duodenum-preserving pancreatic head resection : A local parenchyma-sparing treatment of benign and premalignant tumors of the pancreatic head. Chirurg, 2019 Mar 21. doi: 10.1007/s00104-019-0942-0.
19. Beger HG, Nakao A, Mayer B, et al. Duodenum-preserving total and partial pancreatic head resection for benign tumors—systematic review and meta-analysis. Pancreatology, 2015, 15(2): 167-178.
20. Fujii T, Kanda M, Kodera Y, et al. Comparison of pancreatic head resection with segmental duodenectomy and pylorus-preserving pancreatoduodenectomy for benign and low-grade malignant neoplasms of the pancreatic head. Pancreas, 2011, 40(8): 1258-1263.
21. Gong DJ, Zhang JM, Mao GJ, et al. Duodenum-preserving pancreatic head resection vs. pancreatoduodenectomy for benign lesions and low-grade malignancies of the pancreatic head. Hepatogastroenterology, 2013, 60(121): 19-22.
22. Skórzewska M, Romanowicz T, Mielko J, et al. Frey operation for chronic pancreatitis associated with pancreas divisum: case report and review of the literature. Prz Gastroenterol, 2014, 9(3): 175-178.
23. Snajdauf J, Petru O, Nahlovsky J, et al. Pancreas divisum in children and duodenum-preserving resection of the pancreatic head. Eur J Pediatr Surg, 2018, 28(3): 250-254.
24. Tsuchikawa T, Hirano S, Tanaka E, et al. Modified duodenum-preserving pancreas head resection for low-grade malignant lesion in the pancreatic head. Pancreatology, 2013, 13(2): 170-174.
25. 刘翔琪, 董岿然, 柳龚堡, 等. 保留十二指肠胰头肿块切除术在儿童胰头肿瘤治疗中的应用. 中华小儿外科杂志, 2017, 38(2): 103-106.
26. 覃虹, 董明, 周建平, 等. 保留器官功能胰腺切除术 76 例报告. 中国实用外科杂志, 2012, 32(9): 778-780.
27. Zhang C, Liu F, Chang H, et al. Less aggressive surgical procedure for treatment of solid pseudopapillary tumor: Limited experience from a single institute. PLoS One, 2015, 10(11): e0143452.
28. Zhao X, Cui N, Wang X, et al. Surgical strategies in the treatment of chronic pancreatitis: An updated systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore), 2017, 96(9): e6220.
29. Beger HG, Mayer B. Duodenum-preserving pancreatic head resection in chronic pancreatitis : Limitations of the Heidelberg multicenter ChroPac study. Chirurg, 2018, 89(5): 392-396.
30. 刘续宝. 慢性胰腺炎的胰头炎性包块的外科治疗. 中国普外基础与临床杂志, 2013, 20(2): 121-123.
31. 张太平, 曹喆, 赵玉沛. 慢性胰腺炎合并胰头肿块的外科治疗策略. 中国普外基础与临床杂志, 2016, 23(6): 644-646.
32. Klaiber U, Alldinger I, Probst P, et al. Duodenum-preserving pancreatic head resection: 10-year follow-up of a randomized controlled trial comparing the Beger procedure with the Berne modification. Surgery, 2016, 160(1): 127-135.
33. Snajdauf J, Rygl M, Petru O, et al. Indications and outcomes of duodenum-preserving resection of the pancreatic head in children. Pediatr Surg Int, 2019, 35(4): 449-455.
34. Beger HG, Poch B, Mayer B, et al. New onset of diabetes and pancreatic exocrine insufficiency after pancreaticoduodenectomy for benign and malignant tumors: a systematic review and meta-analysis of long-term results. Ann Surg, 2018, 267(2): 259-270.

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Clinical application and progress of duodenum-preserving pancreatic head resection

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