Pancreatico-duodenectomy

초록

Extrahepatic bile duct cancer is defined as the presence of a malignant tumor arising at the biliary tree distal to second-order branches. Extrahepatic bile duct cancer can be further divided into hilar and distal bile duct cancers. The site of an extrahepatic bile duct cancer has clinical importance because it affects the selection of the appropriate type of surgical resection and outcomes after the surgery. Compared to hilar bile duct cancer, which requires concomitant bile duct and liver resection, surgical resection for a distal bile duct cancer requires pancreaticoduodenectomy with regional lymph node dissection and subsequent reconstruction with a hepaticojejunostomy, pancreaticojejunostomy, and duodenojejunostomy. The first pancreatoduodenectomy was described by Kausch in 1909. The procedure traditionally involves en bloc removal of the gastric antrum, duodenum, pancreatic head, gallbladder, and bile duct. Since its first introduction in 1978 by Traverso and Longmire, the pylorus-preserving technique is now performed for most distal bile duct cancers. © Springer Nature Singapore Pte Ltd. 2023.

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