Pancreas-Preserving Duodenal Resections with Bile and Pancreatic Duct Replantation for Duodenal Dystrophy. Two Case Reports

  • Viacheslav Ivanovich Egorov The Vishnevsky Institute of Surgery. Moscow, Russia
  • Alexander Cezarevich Butkevich Main Hospital of the Russian Federal Security Service. Moscow, Russia
  • Alexander Viacheslavovich Sazhin Russian State Medical University, Pediatric Faculty, Chair of General Surgery. Moscow, Russia
  • Nina Ivanovna Yashina The Vishnevsky Institute of Surgery. Moscow, Russia
  • Sergei Nikolaievich Bogdanov Main Hospital of the Russian Federal Security Service. Moscow, Russia
Keywords: Duodenal Diseases, Duodenal Obstruction, Pancreaticoduodenectomy, Pancreatitis

Abstract

Context Duodenal dystrophy is a rare disease, characterized by the chronic inflammation of the aberrant pancreatic tissue in the duodenal wall. Case reports Two middle-aged men were admitted with upper abdominal pain of several months duration, periodic nausea and vomiting after meals, intermittent jaundice and weight loss. A diagnosis of cystic dystrophy of the vertical part of the duodenum without chronic inflammation of the orthotopic pancreas was established in both cases by multi-detector computed tomography, magnetic resonance imaging and endosonography. Both patients were successfully treated by two modifications of pancreas-preserving duodenal resections with reimplantation of the bile and pancreatic ducts into the neoduodenum. Conclusion These cases are a good example of a pancreas-preserving approach to duodenal dystrophy treatment and can be an alternative to the Whipple procedure in cases of mild changes of the orthotopic gland.

Image: Resected specimen of the second part of the duodenum.

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Resected specimen of the second part of the duodenum
Published
2010-09-06
How to Cite
EgorovV., ButkevichA., SazhinA., YashinaN., & BogdanovS. (2010). Pancreas-Preserving Duodenal Resections with Bile and Pancreatic Duct Replantation for Duodenal Dystrophy. Two Case Reports. JOP. Journal of the Pancreas, 11(5), 446-452. https://doi.org/10.6092/1590-8577/3432