• C F Eisenberger, W T Knoefel, M Peiper, E F Yekebas, S B Hosch, C Busch, and J R Izbicki.
• Department of General Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
• Hepato Gastroenterol. 2004 May 1; 51 (57): 727-31.

Background/AimsPancreas sparing-duodenectomy is an organ-preserving surgical procedure suitable for patients with premalignant or early malignant lesions of the duodenum. The surgical technique is challenging due to the close anatomical relationship between the pancreas and the duodenum.MethodologyAll patients undergoing pancreas-sparing duodenectomy for benign or premalignant condition of the duodenum operated on between 1998 and 2001 were analyzed prospectively. The surgical technique, the hospital course, and complications are described.ResultsA total of four patients underwent pancreas sparing-duodenectomy. Two patients experienced an uncomplicated postoperative course. In one patient, after completing the pancreas sparing-duodenectomy, the operation was converted to a Whipple procedure after the intraoperative diagnosis of malignant disease in the fresh frozen section. One patient had a complicated postoperative course with postoperative pancreatitis requiring several reoperations. At follow-up all patients are well, free of recurrence and alive.ConclusionsPancreas-sparing duodenectomy is a challenging surgical technique and requires excellent knowledge of the anatomy. Intraoperative fresh-frozen section is mandatory to exclude malignant disease. If performed for appropriate indications, pancreas sparing-duodenectomy offers the potential to preserve the anatomical gastrointestinal passage and the integrity of the pancreas.

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