Three cases of distal urgent duodenectomies

Nowadays, duodenal surgery is still complex due to the great morbidity and mortality that is historically associated with. Partial duodenectomies have been described in the literature, usually in the 3rd and 4th portions of the duodenum, with a duodenojejunal anastomosis being subsequently performed. With this technique, good results have been reported in infrapapillary neoplasm surgery. Nevertheless, it is not easy to find published cases of duodenectomies performed urgently, included total and distal D3-D4 duodenectomies. A retrospective analysis has been carried out of the total of urgent D3-D4 partial duodenectomies performed in our hospital, to present our cases. On the other hand, we carried out a systematic review without limits in PubMed. In our department, a total of three urgent D3-D4 partial duodenectomies have been performed. In the review carried out, 436 articles were obtained, of which two were excluded due to their language (Japanese and Russian). Furthermore, 426 articles were excluded because they were not the object of the current study. We can conclude that the morbidity of the procedure, despite the adverse conditions posed by urgent surgery, is acceptable in most cases. Urgent partial duodenectomy is an exceptionally reported procedure in the literature. Despite the few cases, it can be a safe alternative with less morbidity and sequelae than other procedures. However, more systematic studies are needed to consider it systematically.