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Pancreas-Preserving Total Duodenectomy: A Systematic Review
Digestive Surgery ( IF 2.7 ) Pub Date : 2021-05-17 , DOI: 10.1159/000515718
Miguel Cantalejo-Díaz 1 , José Manuel Ramia-Ángel 2 , Ana Palomares-Cano 1 , Mario Serradilla-Martín 3
Affiliation  

Background: The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. Summary: A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo #x3c;IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was #x3e;97.8%. Key Messages: PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.
Dig Surg


中文翻译:

保留胰腺的全十二指肠切除术:系统评价

背景:十二指肠外伤或十二指肠肿瘤患者的胰腺管理仍然是一个有争议的问题。保留胰腺的十二指肠全切术 (PPTD) 需要细致的手术技术。最常见的适应症是家族性十二指肠腺瘤性息肉病 (FAP)。本研究的目的是对有关 PPTD 适应症的文献进行系统回顾,并强调与其他更积极的手术相比的风险和益处。概括:根据 PRISMA 对发表在 PubMed、Embase 和 Cochrane 库中的研究的建议进行了系统的文献回顾,直到 2019 年 5 月。选择了描述 211 名患者的 30 篇文章。平均年龄为 48 岁。75% 患者的手术指征是 FAP。平均手术时间为 329 分钟,平均术中出血量为 412 毫升。术后发病率为 49.7%(76% Clavien-Dindo #x3c;IIIa),死亡率为 1.4%。平均住院时间为 22 天。1-3-5 年的总生存率为 #x3e;97.8%。关键信息: PPTD 适用于不累及胰头的良性和癌前十二指肠病变患者。这是一种可行的程序,可为选定的患者提供其他更具侵略性的程序的替代方案。死亡率低于1.5%。
挖掘外科
更新日期:2021-05-17
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