VENTRAL PANCREATIC RESECTION FOR ADENOMA AND LOW-GRADE MALIGNANCIES OF THE HEAD OF THE PANCREAS

The head of the pancreas ran be anatomically divided into two sections , one drained by the duct of the Santorini system, and the other drain ed by the ventral pancreatic duct. This study was undertaken to determ ine whether independent resection of the ventral pancreas drained by t he ventral pancreatic duct could be performed safely and effectively, by employing the following method in four patients. First, the duodenu m and pancreas mere sufficiently separated preserving the mesoduodenum and the posterior pancreaticoduodenal artery. Next, the main pancreat ic duct was divided at the papillary portion, and sectioned at its jun ction with the duct of Santorini, ensuring preservation of the intrapa ncreatic bile duct. After the ventral pancreas had been detached from the glistening intrapancreatic bile duct, the ventral pancreas was con nected,vith the dorsal pancreas by only the pancreatic parenchyma. The ventral pancreatic resection was completed following the incision of this border, A pancreatic fistula developed in one patient postoperati vely, but this healed within 30 days. The hospital stay after surgery ranged hom 35 to 58 days, and a good quality of life was maintained in all four patients, Thus, we conclude that ventral pancreatic resectio n ran be safely performed and is especially valuable for treating the increasingly frequent adenomas and borderline malignancies in the main pancreatic duct system of the head of the pancreas.