Table 6

 Pancreaticoduodenectomy and pylorus or pancreas preserving duodenectomy for duodenal neoplastic lesions

AuthorTreatmentFollow upPatientsOutcomePostoperative
*That is, wound infection, atelectasis, or urinary tract infection.
†That is, anastomotic leakage, fistula formation, wound abscess, sepsis, or pancreatitis.
NS, not stated; FAP, familial adenomatous polyposis.
Soravia52PancreaticoduodenectomyNS1 FAPUnknownNS
Morpurgo44PancreaticoduodenectomyNS4 FAPNo recurrence reportedIncreased number of bowel movements. One patient required pouch excision and end ileostomy to control diarrhoea. 3 patients experienced weight loss, 1 patients had episodes of pancreatitis
Alarcon46Pancreas sparing duodenectomy40–50 months
>(mean 45.7)
3 FAPNo recurrence. Two of three patients had a small tubular adenoma in the duodenal bulb.NS
Penna57Pancreaticoduodenectomy9–108 months
>(mean 42)
7 FAP severe duodenal polyposisNo recurrence in patients treated for severe duodenal polyposis.1 pancreatic fistula, 1 upper GI haemorrhage
1–9 years5 FAP duodenal cancerOnly 1 patients with duodenal cancer survived >4 yearsResection not possible in 2 because of peritoneal carcinomatosis or distal lymph node involvement
de Vos tot
Pancreaticoduodenectomy7–96 months
>(mean 47)
23 FAPRecurrence in 3, 6 died of metastatic disease5 minor morbidity*, 12 major morbidity†, 1 patient died of postoperative complications
de Vos tot
Pancreas sparing duodenectomy2–15 months
>(mean 11)
6 FAPNo recurrence1 minor morbidity*, 3 major morbidity†
de Vos tot
Pylorus preserving duodenectomy7–93 months
>(mean 45)
12 FAPRecurrence in 3 of 9, 3 died of metastatic disease1 minor morbidity*, 4 major morbidity†
Ruo59(Pylorus preserving) pancreaticoduodenectomy37–162 months
>(mean 70.5)
7 FAP1 patient developed jejunal adenomas 12 years after operation1 patient developed pancreatic ascites
Chung61Pancreas sparing duodenectomy0.5–3 years
>(mean 2.1)
4 FAPNo recurrence1 gastric retention, 1 pancreatic fistula
Kalady[62Pancreas sparing duodenectomy10 years3 FAP1 had polyp recurrence in jejunum at 5 years of follow up1 postoperative wound infection, 1 biliary leak
Balladur63(Pylorus preserving) pancreaticoduodenectomy24 and 28 months2 FAPNo recurrenceNS
Farnell60(Pancreas sparing) pancreaticoduodenectomy0.3–16 years
>(mean 5.6)
25 FAP and sporadicNo recurrences10 leaks, 4 delayed gastric empytying, 1 delirium tremens, 3 abcesses. 1 patient died from bleeding and sepsis related to hepaticojejunostomy leak. Morbidity was higher after pancreas sparing duodenotomy.