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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2021, Vol. 15 ›› Issue (04): 374-374. doi: 10.3877/cma.j.issn.1674-3946.2021.04.005

Special Issue:

• Specialist Operation Broadcast • Previous Articles     Next Articles

Duodenum-CBD-Oddi’s Sphincter-preserving Pancreatic Head en bloc Total Resection (DCOPPHTR)

Shixiang Guo1, Huaizhi Wang1,()   

  1. 1. Institute of Hepatobiliary pancreas Surgery, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 401147, China
  • Online:2021-08-17 Published:2021-08-17
  • Contact: Huaizhi Wang
  • Supported by:
    Research and Development of The National Key Program(2017YFC1308600); The National Natural Science Fund Project(82072723)

Abstract:

DCOPPHTR is based on our new discoveries on the pathological change of chronic pancreatitis and deeper understandings on the anatomy of pancreas. Therefore, DCOPPHTR breaks through Beger’s principles and is a new procedure The main points are as follows: (1) To separate pancreatic head from retroperitoneum by Kocher surgery until we see inferior mesenteric vein.(2) To dissect along SMV and ligate Henle trunk. (3) To dissect GDA and expose main trunk of portal vein.(4) Before cut off the pancreatic neck, we suture the lower and upper edge of pancreatic neck, ligate the proximal end of cut line to decrease bleeding. (5) To inject water into the uncinate of pancreas, dissect along parenchyma and keep the back capsule intact. (6)To dissect along loose connective tissue between duodenum and parenchyma of pancreatic head; ligate artery branches to pancreatic head. (7) To dissect between pancreatic parenchyma and common bile duct; cut off the main pancreatic duct and suture its stump using 5/0 pleiling thread. (8)Pancreaticojejunostomy was performed by duct to mucosa anastomosis.

Key words: Duodenum, Common bile duct, Sphincter of oddi, Pancreatectomy

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