Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)
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Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)

This Open Pylorus Preserving Pancreaticoduodenectomy (PPPD) course will teach you:

  • To resect the pancreatic head, duodenum, proximal jejunum and gallbladder en bloc, while preserving the pylorus of the stomach

Special attention is paid to the following hazards you may encounter during the Open Pylorus Preserving Pancreaticoduodenectomy (PPPD):

  • Common hepatic duct and right hepatic artery injury
  • Common bile duct injury
  • Gastroduodenal artery hemorrhage
  • Middle colic artery injury
  • Superior mesenteric vein or portal vein injury
  • Accessory or displaced right hepatic artery

With the following tips you might perform the Open Pylorus Preserving Pancreaticoduodenectomy (PPPD) even better:

  • Round ligament of the liver preservation
  • Pringle maneuver
  • Gallbladder decompression
  • Dissection plane exposure
  • Fundus first or fundus last cholecystectomy
  • Hepaticojejunostomy preparation (Blumgart technique)
  • Bile duct frozen section
  • Gastroduodenal artery identification
  • Creating tunnel guidance behind pancreatic neck
  • Optimal jejunum dissection
  • Reducing bleeding risk after pancreatic neck transection
  • Prevention of injury to superior mesenteric vein and portal vein during pancreatic neck transection
  • Pancreatic main duct identification
  • Frozen section pancreatic neck resection plane
  • Prevention of pancreatic main duct obstruction
  • End to side anastomosis
  • Postoperative feeding using jejunal feeding tube
  • Gastroduodenal artery stump protection
  • Drain placement
  • Anastomosis preservation

After studying the Open Pylorus Preserving Pancreaticoduodenectomy (PPPD) course you are familiar with the most common complications:

  • Biliairy leakage
  • Duodenojejunostomy leakage
  • Delayed gastric emptying

You might also be interested in:
Open Distal Pancreatectomy
Open Distal Pancreaticosplenectomy

Step by step

Abdominal cavity approach

Skin

Incise

Incise the skin using a Chevron or midline incision. For a more detailed elaboration of this, refer to the course: Abdominal Wall Incision – Chevron or Abdominal Wall Incision – Midline.

Round ligament of the liver preservation

If preserved, the round ligament can later be used as a protective cover or as a vascular interposition graft. It is advised to transect the round ligament of the liver as close to the umbilicus as possible for maximal length.

Do you want to learn the complete step-by-step of "Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)"?

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Do you want to learn the anatomy of "Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)"?

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Do you want to learn the objectives of "Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)"?

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Unlimited access to all 308 courses.

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Do you want to learn the preoperative of "Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)"?

Try one of our offerings

Try-out

Unlock your free Incision procedure

Membership

Unlimited access to all 308 courses.

20 per month Get started

Do you want to learn the postoperative of "Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)"?

Try one of our offerings

Try-out

Unlock your free Incision procedure

Membership

Unlimited access to all 308 courses.

20 per month Get started

Do you want to take the test of "Open Pylorus Preserving Pancreaticoduodenectomy (PPPD)"?

Try one of our offerings

Try-out

Unlock your free Incision course

Free Try course

Membership

Unlimited access to all 308 courses.

20 per month Get started