Pancreas Preserving Duodenectomy (PPrD)

Background Pancreaticoduodenectomy has been the standard of care for managing duodenal neoplasms, but recent studies show similar overall and disease-specific survival after pancreas-preserving duodenectomy (PPrD) with potentially less morbidity. Methods Retrospective cohort of all adult (age > 18) patients who underwent PPrD with curative intent of a neoplasm in or invading into the duodenum at our institution from 2011-2022 (n = 29), excluding tumors involving the Ampulla of Vater or the pancreas. Statistical analyses were performed using STATA. Results R0 resection was achieved in 93% patients. Ten (34.4%) experienced postoperative complications (13.7% within Clavien-Dindo III-V). PPrD patients had lower rates of pancreatic leak, delayed gastric emptying, and deep surgical site infection. Conclusions In this case series, we demonstrate PPrD is safe and effective, with a high rate of complete resection and lower complication rate than that seen in pancreaticoduodenectomy.