Can duodenal resection be a valid alternative to pancreatoduodenectomy for nonampullary duodenal tumors?

BACKGROUND

Pancreatoduodenectomy is still the most common surgical treatment for patients with duodenal tumors. However, in selected cases where duodenal resection is technically feasible, it could represent a valid alternative, reducing the risk of postoperative complications, being a less invasive procedure.

AIMS: The objective of this study was to evaluate the results of this procedure at our institution.

METHODS

We collected data from all patients undergoing duodenal resection for oncologic disease between January 2020 and June 2025 at our institution. After a multidisciplinary evaluation, duodenal resection was indicated when the distance between the duodenal tumor and papilla of Vater measured endoscopically was at least 2 cm, and the tumor was operable with radical intent.

RESULTS

Eight patients were treated with this procedure. No major postoperative complications were observed. Two patients had postoperative nausea and vomiting, which resolved with antiemetics. Average hospital stay was five days. There has been no recurrence or death to date.

CONCLUSIONS

Duodenal resection seems a valid alternative to pancreatoduodenectomy for the treatment of duodenal tumors in selected cases. It reduces the risk of postoperative complications, eliminating the risk of complications specific to pancreatoduodenectomy, such as pancreatic and biliary fistulas. It is a less invasive and shorter procedure, less severely compromises the patients general condition, and reduces hospital stay. Further studies are needed to confirm these results and draw generalizable conclusions.