VS 10 - HPB Pancreas preserving total duodenectomy, How I do it

Abstract Background Patients with duodenal polyps particularly patients with familial adenomatous polyposis syndrome (FAP) are at increased risk of developing duodenal cancer. Pancreas preserving total duodenectomy is an alternative to pancreaticoduodenectomy. Advantages over pancreaticoduodenectomy include: shorter operative time, fewer and safer anastomoses, allowing future endoscopic surveillance and preserving the entire pancreas with both exocrine and endocrine functions. The complication rate is comparable if not fewer than pancreaticoduodenectomy. Here, we present our standardised operative technique for this procedure. Method This a video presentation of the technique of this novel procedure. The video has been edited with added narrative comments on the different steps of the procedure. Results This is a video presentation of the technique of pancreas preserving total duodenectomy in a patient with familial adenomatous polyposis syndrome to treat Spiegelman IV duodenal polyps. Conclusion The PPTD provides a feasible and probably favourable if not better alternative to classical pancreaticoduodenectomy particularly in patients with FAP syndrome.