Duodenum-preserving pancreatic head resection in patients with benign and borderline tumors of the pancreatic head

Background: Benign tumors of the pancreas are rare, accounting for only 1-2 % of primary pancreatic lesions. Up to now: partial duodenopancreatectomy i s still one of the established forms of treatment of benign tumors of the p ancreas. We applied duodenum-preserving pancreatic head resection in 12 pat ients with benign pancreatic tumors to evaluate the feasibility, morbidity and recurrence rates after this less aggressive method. Methods: Between Ap ril 1984 and December 1999, 12 patients with benign and borderline tumors o f the pancreatic head were operated on by duodenum-preserving pancreatic he ad resection. Results: All five patients with serous cystadenoma are free o f recurrence 4.4 years after primary resection. One of two patients with mu cinous cystadenoma and one of three patients with intraductal papillary muc inous tumor developed recurrent tumor within the former pancreatic head 5 y ears and 6 years, respectively, after the primary operation. Both patients were resected a second time. One of two patients with gastrinoma still has elevated serum gastrin levels. There was no hospital or longterm mortality. Conclusion: For a symptomatic serous cystadenoma, duodenum-preserving panc reatic head resection is a good alternative to partial duodenopancreatectom y. In borderline tumors with malignant potential, we would rather suggest a more radical duodenum-preserving segmental resection. A video clip (3 min) is attached demonstrating the basic steps of duodenum-preserving pancreati c head resection.