Reductive Surgery for Periampullary Carcinoma

Yuji Nimura

First Department of Surgery, Nagoya University School of Medicine

Recent progress of preoperative diagnostic techniques have led to show an accurate information of cancer extension and to apply the smallest necessary resection of the organ and dissection of the lymph nodes and autonomic nerve plexus. Pylorus preserving pancreatoduodenectomy (PpPD) has been performed for periampullary carcinoma: carcinoma of the pancreas head, distal bile duct, papilla of Vater and duodenum, and provided better quality of life than that after standard pancreatoduodenetomy (PD). Furthermore early detection of a small cancer, mucosal cancer and borderline lesions have led to develope a duodenum preserving pancreas head resction and several kinds of partial resection of the pancreas head to preserve the functional capacity of the involved organ. However there is continuing controversy as to the technical problems concerning the functional maintenance of the stomach after the pylorus preserving operation, and particular postoperative complications related to the reductive surgery still remain unsolved.

Key words
periampullary carcinoma, pylorus preserving pancreatoduodenectomy, duodenum preserving pancreas head resection

Reprint requests
Yuji Nimura First Department of Surgery, Nagoya University School of Medicine
JAPAN

Accepted
November 9, 1994

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