Limited Parenchyma-Sparing Pancreatic Head Resection for Benign Neuroendocrine Tumors and Cystic Neoplasms-the Use of Duodenum-Preserving Head Resection

Treating benign tumors of the pancreatic head by using duodenum-preserving total or subtotal pancreatic head resection (DPPHRt/s) has proven to reduce mortality and morbidity with a positive postoperative outcome, when compared with the standard approach which is represented by pancreaticoduodenectomy (PD). We present three cases of DPPHRs for benign tumors, in which pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG) were used. The long-term outcome of these patients was favorable; with a single case that presents a rapid onset of an acute pancreatitis, with postoperative pancreatic fistula that necessitate reoperation. The best results on early postoperative outcome were recorded in the case of pancreaticogastrostomy, with rapid onset of digestive tolerance and short period of hospital stay. These cases come in aiding modern surgery by ensuring an alternative to reintegrate the pancreatic remnant into the digestive tract after limited pancreatic head resection, with lower rates of postoperative complications.