Pylorus-Preserving Pancreaticoduodenectomy With Complete Preservation of the Pyloroduodenal Blood Supply and Innervation
Jeffrey M. Gauvin, MD;
Juan M. Sarmiento, MD;
Michael G. Sarr, MD
Arch Surg. 2003;138:1261-1263.
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INTRODUCTION
Pylorus-preserving pancreaticoduodenectomy is an accepted treatment for benign and malignant diseases of the pancreas. Some element of delayed gastric emptying affects as many as 46% of patients.1-2 Although usually transient, delayed gastric emptying may extend length of hospital stay and persist for several weeks. In addition to pancreatic anastomotic leaks,3 reduced blood flow and compromised innervation to the antral-pyloric pump mechanism have been implicated as causes.4-6
We describe a technique for pylorus-preserving pancreaticoduodenectomy that preserves both the right gastric artery and gastroduodenal artery (GDA) and all innervation along the lesser curvature of the stomach and rostral to the proximal duodenum. We hypothesize that this approach will decrease delayed gastric emptying.
TECHNIQUE
After extrapancreatic determination of resectability, the superior mesenteric vein is exposed, and the plane between the superior mesenteric vein and the neck of the pancreas is developed totally . . . [Full Text of this Article]
COMMENT
From the Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minn.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Pancreaticoduodenectomy after esophageal and gastric surgery preserving right gastroepiploic vessels.
Ikeda et al.
Arch Surg 2006;141:205-208.
ABSTRACT
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