Pancreas-Preserving Duodenal Resections with Bile and Pancreatic Duct Replantation for Duodenal Dystrophy. Two Case Reports
Viacheslav Ivanovich Egorov1, Alexander Cezarevich Butkevich2, Alexander Viacheslavovich Sazhin3, Nina Ivanovna Yashina1, Sergei Nikolaievich Bogdanov2
1The Vishnevsky Institute of Surgery; 2Main Hospital of the Russian Federal Security Service; 3Russian State Medical University, Pediatric Faculty, Chair of General Surgery. Moscow, Russia
Context Duodenal dystrophy is a rare disease, characterized by the chronic inflammation of the aberrant pancreatic tissue in the duodenal wall. Case reports Two middle-aged men were admitted with upper abdominal pain of several months duration, periodic nausea and vomiting after meals, intermittent jaundice and weight loss. A diagnosis of cystic dystrophy of the vertical part of the duodenum without chronic inflammation of the orthotopic pancreas was established in both cases by multi-detector computed tomography, magnetic resonance imaging and endosonography. Both patients were successfully treated by two modifications of pancreas-preserving duodenal resections with reimplantation of the bile and pancreatic ducts into the neoduodenum. Conclusion These cases are a good example of a pancreas-preserving approach to duodenal dystrophy treatment and can be an alternative to the Whipple procedure in cases of mild changes of the orthotopic gland.
