Primary division of annular pancreas: a surgical technique.

Lim, Kai-Zheong; Lee, Alice; Croagh, Daniel

The authors presented a case of duodenal obstruction in a 61-year-old man, resulting from an annular pancreas diagnosed on imaging (computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasound). The patient underwent a diagnostic laparoscopy. Intraoperatively, given a straightforward appearance and anatomy of the annular pancreas overlying the second part of the duodenum, and due to extensive adhesions in the abdomen, a primary division of the annular pancreas was performed, instead of a bypass procedure such as gastrojejunostomy. He had some residual symptoms 1 week postoperatively which was treated with duodenal dilatation endoscopically. On review and follow-up at 1 year, he has remained well with resolution of symptoms, supported by radiological improvement on a computed tomography performed at 4 months post-operatively. We believe this approach has resulted in less morbidity and a shorter period of recovery as compared to a bypass procedure and represents a reasonable therapeutic option for annular pancreas.

GASTRIC outlet obstruction; DUODENAL obstructions; LAPAROSCOPIC surgery; COMPUTED tomography; MAGNETIC resonance

Journal of Surgical Case Reports, 2024, Vol 2024, Issue 11, p1

2042-8812

Academic Journal

10.1093/jscr/rjae712