Pylorus- and spleen-preserving total pancreatoduodenectomy with resection of both whole splenic vessels: Feasibility and laparoscopic application to intraductal papillary mucin-producing tumors of the pancreas

Sung Hoon Choi, Ho Kyoung Hwang, Chang Moo Kang, Chang Ik Yoon, Woo Jung Lee

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14 Citations (Scopus)


Background: Total pancreatectomy is recommended for intraductal papillary mucinous tumors with widespread involvement of the entire pancreas. Organ-preserving and minimally invasive surgery should be applied in benign and borderline pancreatic lesions. Methods: Pylorus- and spleen-preserving total pancreatoduodenectomy (PpSpTPD) with segmental resection of both splenic vessels was attempted for five patients. The technique was based on the concepts of two surgical procedures: pylorus-preserving pancreatoduodenectomy and distal pancreatectomy with segmental resection of splenic vessels ("extended" Warshaw's procedure). Results: Three patients underwent laparoscopic-assisted PpSpTPD and two underwent open surgery. No mortality was noted. Short-term follow-up (median, 28 months) suggested that all patients tolerated the insulin therapy and showed relatively good nutritional status. Only minimal to moderate perigastric fundal varices were noted without gastrointestinal bleeding. Conclusions: PpSpTPD with segmental resection of both splenic vessels is feasible and safe. Even a minimally invasive approach can be indicated in selected patients.

Original languageEnglish
Pages (from-to)2072-2077
Number of pages6
JournalSurgical endoscopy
Issue number7
Publication statusPublished - 2012 Jul


All Science Journal Classification (ASJC) codes

  • Surgery

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