Surgical resection of space occupying with extensive calcification of pancreatic head_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHU Yunjie , WANG Li , CHEN Yang ,  TIAN Bole

Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

TIAN Bole, Email: hxtbl0338@126.com

Keywords：

space occupying of pancreatic head; extensive calcification of pancreatic head; duodenum-preserving resection of pancreatic head; prognosis

DOI：

10.7507/1007-9424.201805089

Video：

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Objective To estimate the prognosis of duodenum-preserving resection of pancreatic head (DPRPH) in the treatment of space occupying with extensive calcification of pancreatic head, and to summarize the key points of surgery.Methods The clinical data of a middle-aged woman with rare space occupying with extensive calcification of pancreatic head who underwent surgery in Department of Pancreatic Surgery of West China Hospital in May. 2016 was collected and analyzed.Results The DPRPH operation was successfully completed, with the operative time was 207 min, the intraoperative blood loss was 130 mL, and the hospital stay was 12 d. Removing time of the gastric tube and off-bed activity were on the 3^rd day after operation, and the volume of peritoneal drainage per day was decreasing from 30 mL to 10 mL until 7^th day after operation. We made examination of serum amylase and fluid amylase for the patient every 2 days, and the examination indexes were within normal level. After removing the peritoneal drainage tube, the pain was obviously relieved on the 12^th day after operation, then the patient made hospital discharge. There was no observable pancreatic fistula, duodenal fistula, biliary fistula, delay gastric emptying, peritoneal effusion, pleural effusion, abdominal infection, and abdominal bleeding, neither nor any special discomfort. During the follow-up period of 18 months, we got a good prognosis without any symptom of relapse or discomfort according to the result of CT scans and other examinations.Conclusion DPRPH can make a satisfied prognosis in the treatment of rare space occupying with extensive calcification of pancreatic head.

Citation： ZHU Yunjie, WANG Li, CHEN Yang, TIAN Bole. Surgical resection of space occupying with extensive calcification of pancreatic head. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(1): 82-85. doi: 10.7507/1007-9424.201805089 Copy

1.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
2.	Smits FJ, van Santvoort HC, Besselink MG, et al. Management of severe pancreatic fistula after pancreatoduodenectomy. JAMA Surg, 2017, 152(6): 540-548.
3.	El Nakeeb A, Salem A, Mahdy Y, et al. Value of preoperative biliary drainage on postoperative outcome after pancreatico- duodenectomy: a case-control study. Asian J Surg, 2018, 41(2): 155-162.
4.	Beger HG, Witte C, Meves M, et al. Experiences in organ-preserving surgical methods in the treatment of gastroduodenal ulcers. Results after vagotomy and pyloroplasty. Chirurg, 1972, 43(3): 127-131.
5.	Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas, 1987, 2(6): 701-707.
6.	Büchler MW, Bassi C, Fingerhut A, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Ann Surg, 2001, 234(2): 262-263.
7.	Nassani N, Tong GX, Zheng X, et al. Pancreatic head cystic lesion resembling a pancreatic cystic neoplasm corresponding to a tonsillar squamous cell carcinoma metastasis to the pancreas. Am J Gastroenterol, 2017, 112(S1): S695.
8.	Sethi S, Puri SK, Agarwal A. Primary pancreatic hydatid: a rare cystic lesion of the pancreas. Am J Trop Med Hyg, 2017, 96(4): 763-764.
9.	Goh BKP, Kwek ABE, Wan WK. An unusual cause of a solid-cystic pancreatic lesion. Gastroenterology, 2018, 154(4): e4-e5.
10.	Schneider M, Lesurtel M, Weber A. Pancreatic cystic lesion with baffling fluid levels of CEA and amylase. J Gastrointestin Liver Dis, 2016, 25(3): 270.
11.	Choi JY, Kim MJ, Kim JH, et al. Solid pseudopapillary tumor of the pancreas: typical and atypical manifestations. AJR Am J Roentgenol, 2006, 187(2): W178-W186.
12.	Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
13.	Niesen W, Hank T, Angelova Y, et al. Patient-reported long-term outcomes after duodenum-preserving pancreatic head resection (berne modification) for chronic pancreatitis. Pancreatology, 2017, 17(3): S88-S89.
14.	Beger HG, Mayer B. Duodenum-preserving pancreatic head resection in chronic pancreatitis: limitations of the Heidelberg multicenter ChroPac study. Chirurg, 2018, 89(5): 392-396.
15.	Kemper M, Izbicki JR, Bachmann K. Surgical treatment of chronic pancreatitis: the state of the art. Chirurgia (Bucur), 2018, 113(3): 300-306.
16.	Milanetto AC, Liço V, Alaggio R, et al. Duodenum preserving pancreatic head resection for treatment of neuroendocrine pancreatic tumors of the head of the pancreas. Pancreatology, 2016, 16(3): S65-S66.
17.	Beger HG. Benign tumors of the pancreas-radical surgery versus parenchyma-sparing local resection-the challenge facing surgeons. J Gastrointest Surg, 2018, 22(3): 562-566.
18.	Gurusamy KS, Lusuku C, Halkias C, et al. Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis. Cochrane Database Syst Rev, 2016, 2: CD011521.
19.	Chen J, Jiang K, Wu J, et al. Application of intraoperative transluminal core-biopsy for diagnosis of pancreatic head mass: a single center 15-year experience. Pancreatology, 2018, 18(1): 68-72.
20.	Radenkovic D, Farnell MB, Bassi C, et al. Evolving techniques in pancreatic surgery. Gastroenterol Res Pract, 2016, 2016: 4289724.

1. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
2. Smits FJ, van Santvoort HC, Besselink MG, et al. Management of severe pancreatic fistula after pancreatoduodenectomy. JAMA Surg, 2017, 152(6): 540-548.
3. El Nakeeb A, Salem A, Mahdy Y, et al. Value of preoperative biliary drainage on postoperative outcome after pancreatico- duodenectomy: a case-control study. Asian J Surg, 2018, 41(2): 155-162.
4. Beger HG, Witte C, Meves M, et al. Experiences in organ-preserving surgical methods in the treatment of gastroduodenal ulcers. Results after vagotomy and pyloroplasty. Chirurg, 1972, 43(3): 127-131.
5. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas, 1987, 2(6): 701-707.
6. Büchler MW, Bassi C, Fingerhut A, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Ann Surg, 2001, 234(2): 262-263.
7. Nassani N, Tong GX, Zheng X, et al. Pancreatic head cystic lesion resembling a pancreatic cystic neoplasm corresponding to a tonsillar squamous cell carcinoma metastasis to the pancreas. Am J Gastroenterol, 2017, 112(S1): S695.
8. Sethi S, Puri SK, Agarwal A. Primary pancreatic hydatid: a rare cystic lesion of the pancreas. Am J Trop Med Hyg, 2017, 96(4): 763-764.
9. Goh BKP, Kwek ABE, Wan WK. An unusual cause of a solid-cystic pancreatic lesion. Gastroenterology, 2018, 154(4): e4-e5.
10. Schneider M, Lesurtel M, Weber A. Pancreatic cystic lesion with baffling fluid levels of CEA and amylase. J Gastrointestin Liver Dis, 2016, 25(3): 270.
11. Choi JY, Kim MJ, Kim JH, et al. Solid pseudopapillary tumor of the pancreas: typical and atypical manifestations. AJR Am J Roentgenol, 2006, 187(2): W178-W186.
12. Diener MK, Hüttner FJ, Kieser M, et al. Partial pancreatoduodenectomy versus duodenum-preserving pancreatic head resection in chronic pancreatitis: the multicentre, randomised, controlled, double-blind ChroPac trial. Lancet, 2017, 390(10099): 1027-1037.
13. Niesen W, Hank T, Angelova Y, et al. Patient-reported long-term outcomes after duodenum-preserving pancreatic head resection (berne modification) for chronic pancreatitis. Pancreatology, 2017, 17(3): S88-S89.
14. Beger HG, Mayer B. Duodenum-preserving pancreatic head resection in chronic pancreatitis: limitations of the Heidelberg multicenter ChroPac study. Chirurg, 2018, 89(5): 392-396.
15. Kemper M, Izbicki JR, Bachmann K. Surgical treatment of chronic pancreatitis: the state of the art. Chirurgia (Bucur), 2018, 113(3): 300-306.
16. Milanetto AC, Liço V, Alaggio R, et al. Duodenum preserving pancreatic head resection for treatment of neuroendocrine pancreatic tumors of the head of the pancreas. Pancreatology, 2016, 16(3): S65-S66.
17. Beger HG. Benign tumors of the pancreas-radical surgery versus parenchyma-sparing local resection-the challenge facing surgeons. J Gastrointest Surg, 2018, 22(3): 562-566.
18. Gurusamy KS, Lusuku C, Halkias C, et al. Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis. Cochrane Database Syst Rev, 2016, 2: CD011521.
19. Chen J, Jiang K, Wu J, et al. Application of intraoperative transluminal core-biopsy for diagnosis of pancreatic head mass: a single center 15-year experience. Pancreatology, 2018, 18(1): 68-72.
20. Radenkovic D, Farnell MB, Bassi C, et al. Evolving techniques in pancreatic surgery. Gastroenterol Res Pract, 2016, 2016: 4289724.

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Surgical resection of space occupying with extensive calcification of pancreatic head

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