Option of isolated pancreatic head resection in chronic pancreatitis

Abstract

The paper presents two clinical observations of successful duodenum-preserving pancreatic head resection performed for chronic calcifying pancreatitis complicated by ductal hypertension. At the reconstructive stage, an isolated segment of jejunum, 20 cm from the ligament of Treitz, was used. It was placed behind the colon. The patients had pancreatojejunostomosis formed with the wound surface of the pancreatic head and duct, and duodenojejunostomosis with the lower horizontal part of the duodenum. The first patient had no complications in the postoperative period. After 6 months, the patient showed improvement in the external secretory function of the pancreas, with absence of pain syndrome. The second patient developed gastrointestinal bleeding on day 10 and underwent endoscopic hemostasis. In 1.5, the esophagogastroduodenoscopy revealed patent anastomosis, without signs of inflammation. The applied variant of surgery enables pancreatic juice to be secreted as close to anatomical and physiological conditions as possible. Furthermore, the method allows endoscopic hemostasis to be performed in case of bleeding from the anastomosis zone. Further study is required on the long-term results of the proposed option of surgery.