Laparoscopic duodenum-preserving pancreatic head resection: surgical key points and challenges_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SUN Pijiang ¹ , CUI Shang ² , YANG Yongjun ¹ , RAN Chao ¹

1. Institute of Hepatopancreatobiliary Surgery, Chongqing General Hospital, Chongqing University, Chongqing 401147, P. R. China;
2. Qingdao University Medical College, Qingdao 266071, P. R. China;

Corresponding author：

SUN Pijiang, Email: beciham@163.com

Keywords：

laparoscopic duodenum-preserving pancreatic head resection; benign pancreatic head tumor; low-grade malignant pancreatic head tumor; pancreatic head stone; chronic pancreatitis

DOI：

10.7507/1007-9424.202502030

Video：

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Abstract Full text Figures/Tables Video References Cited by

Duodenum-preserving pancreatic head resection (DPPHR) is a surgical approach indicated for benign or low-grade malignant tumors of the pancreatic head, pancreatic duct stones in the pancreatic head, chronic pancreatitis, and related pathologies. Compared to traditional pancreaticoduodenectomy (PD), its core principle lies in preserving the integrity of the stomach, duodenum, and biliary tract, thereby reducing postoperative digestive dysfunction and metabolic complications to improve patients’ quality of life. With the continuous advancement of laparoscopic techniques, laparoscopic duodenum-preserving pancreatic head resection (LDPPHR) has emerged as a significant refinement of conventional PD, achieving an optimal integration of minimally invasive laparoscopy and organ function preservation. This article synthesizes recent Chinese and English literature to provide a systematic review of surgical indications, technical nuances, complication management, and clinical outcomes of LDPPHR.

Citation： SUN Pijiang, CUI Shang, YANG Yongjun, RAN Chao. Laparoscopic duodenum-preserving pancreatic head resection: surgical key points and challenges. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(2): 152-155. doi: 10.7507/1007-9424.202502030 Copy

1.	Beger HG, Krautzberger W, Bittner R, et al. Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 1985, 97(4): 467-473.
2.	Justo Alonso I, Marcacuzco Quinto A, Caso Maestro O, et al. Whipple’s cephalic pancreaticoduodenectomy versus pyloric-preserving pancreaticoduodenectomy. Retrospective study. Cir Esp (Engl Ed), 2024, 102(5): 265-274.
3.	Beger HG, Friess H, Uhl W. Whipple resection for benign tumors and premalignant neoplasms of the pancreatic head: surgery-associated risk for complications and late metabolic morbidity matters. Ann Surg Open, 2023, 4(3): e325. doi: 10.1097/AS9.0000000000000325.
4.	Wujimaimaiti N, Wu Y, Yuan JX, et al. Laparoscopic duodenum-preserving pancreatic head resection: a narrative review. J Pancr, 2021, 4(4): 146-152.
5.	Zhou J, Zhou Y, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection: a case report. Medicine (Baltimore), 2016, 95(32): e4442. doi: 10.1097/MD.0000000000004442.
6.	Cai Y, Zheng Z, Gao P, et al. Laparoscopic duodenum-preserving total pancreatic head resection using real-time indocyanine green fluorescence imaging. Surg Endosc, 2021, 35(3): 1355-1361.
7.	陈智猛, 孙瑞, 赖魁元, 等. 腹腔镜保留十二指肠胰头切除术单中心初步经验: 附10例报告. 中国普通外科杂志, 2024, 33(3): 448-455.
8.	钱道海, 刘斌, 金凯舟, 等. 应用动脉后弓优先入路行腹腔镜保留十二指肠胰头切除术12例临床分析. 中国实用外科杂志, 2023, 43(7): 782-784, 795.
9.	董志毅. 保留十二指肠的胰头切除术在胰头部良性病变中的应用及对术后生活质量的影响研究. 中华普外科手术学杂志 (电子版), 2017, 11(6): 528-530.
10.	贺永刚, 唐艺宸, 彭雪辉, 等. 全腹腔镜保留十二指肠胰头切除术体会. 肝胆胰外科杂志, 2021, 33(2): 96-98.
11.	Sun PJ, Yu YH, Li JW, et al. A novel anastomosis technique for laparoscopic pancreaticoduodenectomy: case series of our center’s experience. Front Surg, 2021, 8: 583671. doi: 10.3389/fsurg.2021.583671.
12.	Lu C, Xu B, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity. Langenbecks Arch Surg, 2022, 407(7): 2823-2832.
13.	Chen S, Gao P, Cai H, et al. Indocyanine green-enhanced fluorescence in laparoscopic duodenum-preserving pancreatic head resection: technique with video. Ann Surg Oncol, 2020, 27(10): 3926-3927.
14.	谭明达, 颜军, 郭诗翔. 保留十二指肠、胆总管、Oddi括约肌的胰头整块全切除术后并发症分析. 中华肝脏外科手术学电子杂志, 2024, 13(2): 145-150.
15.	贺卓, 王进峰, 罗建红, 等. 胰十二指肠切除术150例围手术期并发症临床分析. 中国普通外科杂志, 2021, 30(3): 357-364.
16.	Hong D, Cheng J, Wu W, et al. How to perform total laparoscopic duodenum-preserving pancreatic head resection safely and efficiently with innovative techniques. Ann Surg Oncol, 2021, 28(6): 3209-3216.
17.	孙浦, 徐寅凯, 何骏, 等. 保留十二指肠胰头全切除术11例临床分析. 肝胆胰外科杂志, 2024, 36(2): 75-80.
18.	杨永君, 向吉锋, 王槐志. 保留十二指肠、胆总管、Oddi’s括约肌的胰头整块全切除术 (王氏手术)的手术要点及应用. 中国普外基础与临床杂志, 2025, 32(2): 143-147.

1. Beger HG, Krautzberger W, Bittner R, et al. Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis. Surgery, 1985, 97(4): 467-473.
2. Justo Alonso I, Marcacuzco Quinto A, Caso Maestro O, et al. Whipple’s cephalic pancreaticoduodenectomy versus pyloric-preserving pancreaticoduodenectomy. Retrospective study. Cir Esp (Engl Ed), 2024, 102(5): 265-274.
3. Beger HG, Friess H, Uhl W. Whipple resection for benign tumors and premalignant neoplasms of the pancreatic head: surgery-associated risk for complications and late metabolic morbidity matters. Ann Surg Open, 2023, 4(3): e325. doi: 10.1097/AS9.0000000000000325.
4. Wujimaimaiti N, Wu Y, Yuan JX, et al. Laparoscopic duodenum-preserving pancreatic head resection: a narrative review. J Pancr, 2021, 4(4): 146-152.
5. Zhou J, Zhou Y, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection: a case report. Medicine (Baltimore), 2016, 95(32): e4442. doi: 10.1097/MD.0000000000004442.
6. Cai Y, Zheng Z, Gao P, et al. Laparoscopic duodenum-preserving total pancreatic head resection using real-time indocyanine green fluorescence imaging. Surg Endosc, 2021, 35(3): 1355-1361.
7. 陈智猛, 孙瑞, 赖魁元, 等. 腹腔镜保留十二指肠胰头切除术单中心初步经验: 附10例报告. 中国普通外科杂志, 2024, 33(3): 448-455.
8. 钱道海, 刘斌, 金凯舟, 等. 应用动脉后弓优先入路行腹腔镜保留十二指肠胰头切除术12例临床分析. 中国实用外科杂志, 2023, 43(7): 782-784, 795.
9. 董志毅. 保留十二指肠的胰头切除术在胰头部良性病变中的应用及对术后生活质量的影响研究. 中华普外科手术学杂志 (电子版), 2017, 11(6): 528-530.
10. 贺永刚, 唐艺宸, 彭雪辉, 等. 全腹腔镜保留十二指肠胰头切除术体会. 肝胆胰外科杂志, 2021, 33(2): 96-98.
11. Sun PJ, Yu YH, Li JW, et al. A novel anastomosis technique for laparoscopic pancreaticoduodenectomy: case series of our center’s experience. Front Surg, 2021, 8: 583671. doi: 10.3389/fsurg.2021.583671.
12. Lu C, Xu B, Mou Y, et al. Laparoscopic duodenum-preserving pancreatic head resection with real-time indocyanine green guidance of different dosage and timing: enhanced safety with visualized biliary duct and its long-term metabolic morbidity. Langenbecks Arch Surg, 2022, 407(7): 2823-2832.
13. Chen S, Gao P, Cai H, et al. Indocyanine green-enhanced fluorescence in laparoscopic duodenum-preserving pancreatic head resection: technique with video. Ann Surg Oncol, 2020, 27(10): 3926-3927.
14. 谭明达, 颜军, 郭诗翔. 保留十二指肠、胆总管、Oddi括约肌的胰头整块全切除术后并发症分析. 中华肝脏外科手术学电子杂志, 2024, 13(2): 145-150.
15. 贺卓, 王进峰, 罗建红, 等. 胰十二指肠切除术150例围手术期并发症临床分析. 中国普通外科杂志, 2021, 30(3): 357-364.
16. Hong D, Cheng J, Wu W, et al. How to perform total laparoscopic duodenum-preserving pancreatic head resection safely and efficiently with innovative techniques. Ann Surg Oncol, 2021, 28(6): 3209-3216.
17. 孙浦, 徐寅凯, 何骏, 等. 保留十二指肠胰头全切除术11例临床分析. 肝胆胰外科杂志, 2024, 36(2): 75-80.
18. 杨永君, 向吉锋, 王槐志. 保留十二指肠、胆总管、Oddi’s括约肌的胰头整块全切除术 (王氏手术)的手术要点及应用. 中国普外基础与临床杂志, 2025, 32(2): 143-147.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic duodenum-preserving pancreatic head resection: surgical key points and challenges

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