Pancreas-Preserving Approach to “Paraduodenal Pancreatitis” Treatment: Why, When, and How? Experience of Treatment of 62 Patients with Duodenal Dystrophy

Figure 6

Isolated form of the duodenal dystrophy (DD). Male, 57 y.o. Itraoperative photo. Front view. The subtotal duodenectomy is performed: the first, third and fourth portions of the duodenum are detached from the pancreas head (PH) and removed. Jejunum transferred from below is becoming the neoduodenum (ND). The posterior wall of the choledocho-pancreatico-jejunostomy is sutured by duct to mucosa technique. The tip of the common bile drain duct and stent in the narrow pancreatic duct are visible. Marked fibrotic massif (F) surrounds the pancreatic head (PH) and will be used to cover the front wall of the anastomosis.