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Gastroenterol 2007,21(2):117–23.PubMed Competing interests The authors declare that they have no competing interests. Authors’ contributions MIS: Performance of cases, writing and compiling of manuscript, review of literature, selection of figures. AS: Review of literature, writing and compiling of manuscript and tables, editing and selection of figures.”
“Background In recent years a pancreas-sparing duodenal excision (PSD) was introduced for the treatment of certain duodenal pathologies. This technique consists of total duodenal excision including the papilla of Vater with sparing of adjacent tissues, learn more particularly pancreatic parenchyma and the distal biliary and pancreatic ducts. PSD is less invasive than the formal pancreatico-duodenectomy and is indicated in selected cases of benign or traumatic lesions of the duodenum [1–3]. The benefits of this technique were described recently in patients with benign duodenal tumours [4, 5]. Partial excisions of the duodenum to treat various malignant tumours involving the duodenal wall are also widely described in the literature [2, 6–8]. The generous blood supply

that remains, despite partially resecting signaling pathway the first two parts of duodenum, greatly assists in the success of closure by simple suturing. Under some circumstances it is necessary to resect the third and fourth part of the duodenum and reconstruct the duodeno-jejunal junction below the papilla [8]. The complex anatomy and common blood supply of the pancreatico-duodenal region both contribute to technically difficult and prolonged operations [9], therefore

performing a PSD an emergency is considered only under specific conditions and is generally avoided. The emergency PSD (EPSD) is uncommonly described and rarely in patients suffering trauma [4, 10]. The aim of this paper is to describe a series of five patients Phosphoglycerate kinase treated successfully in the emergency setting with pancreas-sparing duodenectomy as well as identify factors that may have contributed to the successful outcomes we have observed. Methods Patients Five patients underwent emergency pancreas-sparing duodenectomies during 2002 – 2007. Data was retrospectively collected and analysed from inpatient records and outpatient documentation. The use of patients’ records for the purpose of this article was approved by local Ethical Committee at Medical University of Lublin, Poland (decision number KE-0254/216/2008). The clinical features, duration of surgery, intra-operative blood loss, length of intensive care unit admission and total hospital stay were studied. The outcomes and complications were also reviewed. Surgical management A xypho-umbilical laparotomy was performed in all cases.