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Duodenum-Preserving Pancreatic Head Resection

Organ-preserving surgery in chronic pancreatitis and benign lesions.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Duodenum-Preserving Pancreatic Head Resection?

Duodenum-preserving pancreatic head resection (DPPHR) is an organ-preserving surgery for chronic pancreatitis and benign or low-grade malignant lesions in which the duodenum, bile duct and stomach are preserved while only the pancreatic head is resected.

In the Beger procedure the pancreatic head is subtotally resected and the duodenum is supplied via mesenteric vessels. In the Frey procedure the pancreatic head is cored coronally and a longitudinal pancreaticojejunostomy is constructed.

DPPHR is less invasive than the Whipple procedure and preserves gastrointestinal anatomy. Pain control is comparable to Whipple, while endocrine and exocrine functions are better preserved and short-term quality of life is higher.

Symptoms

Chronic calcific pancreatitis
Inflammatory pancreatic head mass
Recurrent severe pancreatitis attacks
Benign cystic lesions of the pancreatic head
Low-grade IPMN
Main pancreatic duct dilation (>7 mm)
Pain refractory to conservative therapy
Obstructive jaundice (selected cases)

Risk Factors

Pancreatic fistula (10-20%)
Hepaticojejunostomy leak
Duodenal ischaemia
Delayed gastric emptying
Bleeding
Worsening of diabetes
Exocrine insufficiency
Risk of malignant transformation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe abdominal pain and fever
  • High amylase in drainage
  • Jaundice and rising bilirubin
  • Gastric emptying disorder
  • Hypoglycaemia or hyperglycaemia
  • Steatorrhoea and weight loss

Treatment Methods

01
Multidisciplinary evaluation (pancreatologist, surgeon)
02
MRCP and endoscopic ultrasound mapping
03
Selection of Beger, Frey or Berne modification
04
Subtotal resection of the pancreatic head
05
Decompression of the main pancreatic duct (Frey)
06
Roux-en-Y pancreaticojejunostomy
07
Preservation of the duodenum and bile duct
08
Individualised enzyme and insulin support

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.