[Cephalic duodenopancreatectomy with preservation of the pylorus in treating a malignant tumor of Vater's ampulla].

The paper reports on the clinical observation of a patient with mechanical jaundice in which the biliary obstruction was caused by an ampulla of Vater. Cephalic duodenopancreatectomy with preservation of the pylorus was used. Distally the duodenum was excised to its intersection with the mesenteric vessels. For recovery of the digestive circuits, a loop excluded "en Y" à la Roux ascending transmesocolically was used. The anastomoses had the following stages: choledochojejunostomy (T-T) the most proximal; pancreatic-jejunal anastomosis (T-L); and the most distal, the duodeno-jejunal one (T-L). After surgery, the evolution was good, and the patient left the hospital with the wound cured. Starting from this observation, the authors discuss aspects connected with the technique of cephalic duodenopancreatectomy with or without preservation of the pylorus.