Clinical Outcomes of Duodenum-Preserving Core Pancreatic Head Resection (DP-CoPHR)

Background: Compared with pancreaticoduodenectomy, duodenum-preserving pancreatic head resection (DPPHR) is superior for resecting benign or low-grade malignant tumors located in the core area (adjacent to major ducts) of the pancreatic head. However, this procedure is technically complex. We developed a modified technique, duodenum-preserving core pancreatic head resection (DP-CoPHR), designed to simplify the procedure. This study evaluates its clinical outcomes. Methods: We retrospectively analyzed 6 patients with benign or low-grade malignant tumors located in the core region of the pancreatic head who underwent laparoscopic DP-CoPHR. Results: All 6 patients (median age 26; 3 male and 3 female) successfully completed laparoscopic DP-CoPHR. Pathology revealed solid pseudopapillary neoplasm (n=4), serous cystic neoplasm (n=1), and IPMN (n=1); median tumor diameter was 4.6 cm. The median operative time was 267.5 minutes, the estimated blood loss was 100 mL, and the postoperative hospital stay was 11.5 days. Pancreatic fistula (grade B) occurred in 3 patients (50%). A biliary fistula occurred in 1 patient and was managed with ERBD. No perioperative mortalities or reoperations were recorded. Conclusion: Laparoscopic DP-CoPHR is an alternative procedure for selected patients with benign or low-grade malignant tumors in the core region of the pancreatic head. Long-term follow-up is required to confirm the patency of the common bile duct.