Scientific article
Case report
English

Modified digestive reconstruction with midgut transposition after pylorus-preserving pancreaticoduodenectomy for pancreatic head tumor in childhood

Published inJournal of pediatric surgery, vol. 43, no. 10, p. 1932-1934
Publication date2008
Abstract

We describe a new procedure of digestive reconstruction after pylorus-preserving pancreaticoduodenectomy in a 13-year-old girl presenting with a large solid and papillary epithelial neoplasm of the pancreatic head. A midgut transposition (like in a cure of midgut malrotation) was easily performed after tumor removal with minimal additional dissection. Bilio- and pancreaticodigestive anastomoses were performed on 2 separate Roux-en-Y loops, placed behind the postpyloric jejunal loop. Separate biliary and pancreatic conduits prevented both activation of pancreatic enzymes at the pancreatic duct anastomosis and reflux of pancreatic juice in the bile ducts. Midgut transposition avoided any traction or twist of the 3 isoperistaltic intestinal loops. Postoperative course was uneventful. This technique may be useful after pancreatic head resections in children and adolescents.

Keywords
  • Adolescent
  • Anastomosis, Roux-en-Y
  • Cystadenoma, Papillary/*surgery
  • Enzymes/therapeutic use
  • Exocrine Pancreatic Insufficiency/drug therapy/etiology
  • Female
  • Humans
  • Jejunum/surgery
  • Pancreatic Neoplasms/*surgery
  • Pancreaticoduodenectomy/adverse effects/*methods
  • Pylorus
  • Remission Induction
Citation (ISO format)
UCHIDA, Keiichi et al. Modified digestive reconstruction with midgut transposition after pylorus-preserving pancreaticoduodenectomy for pancreatic head tumor in childhood. In: Journal of pediatric surgery, 2008, vol. 43, n° 10, p. 1932–1934. doi: 10.1016/j.jpedsurg.2008.03.059
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ISSN of the journal0022-3468
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