@article {11208,
	title = {Non-Whipple Operations in the Management of Benign, Premalignant and Early Cancerous Duodenal Lesions.},
	journal = {Anticancer Res},
	volume = {37},
	year = {2017},
	month = {2017 03},
	pages = {1443-1452},
	abstract = {AIM: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions.

PATIENTS AND METHODS: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed.

RESULTS: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy. The mean follow-up was 25.8 months (range=6-54 months) and no patient was lost to follow-up. Eighteen patients had preoperative diagnosis of duodenal adenomatosis, three patients had preoperative diagnosis of duodenal adenocarcinoma, one had a bleeding polyp and two had localized inflammation. Average operative time was 145 min (range=127-168 min) for transduodenal ampullectomy and 183 min (range=173-200 min) for pancreas-preserving duodenectomy (p<0.05). The estimated blood loss for transduodenal ampullectomy was 85 vs. 125 ml for pancreas-preserving duodenectomy (p<0.05). Early postoperative complications were noted in 13 cases (54.17\%). There were no postoperative (90-day) deaths observed in this series and there were no recurrences during follow-up for the patients operated on with neoplastic lesions.

CONCLUSION: For carefully selected patients, transduodenal ampullectomy and pancreas-preserving duodenectomy may be used in place of the Whipple operation for benign and occasionally early-stage malignant (Tis and T1) duodenal and ampullary disease.},
	keywords = {Adult, Aged, Aged, 80 and over, Algorithms, Ampulla of Vater, Anastomosis, Surgical, Decision Making, Duodenal Neoplasms, Female, Follow-Up Studies, Humans, Inflammation, Male, Middle Aged, Neoplasm Recurrence, Local, Operative Time, Postoperative Complications, Retrospective Studies, Surgical Oncology, Treatment Outcome},
	issn = {1791-7530},
	doi = {10.21873/anticanres.11468},
	author = {Papalampros, Alexandros and Moris, Demetrios and Petrou, Athanasios and Dimitrokallis, Nikolaos and Karavokyros, Ioannis and Schizas, Dimitrios and Delladetsima, Ioanna and Pappas, Theodore N and Felekouras, Evangelos}
}
