Duodenum-preserving resection and Roux-en-Y pancreatic jejunostomy in benign pancreatic head tumors

Figure 1 B-ultrasonic examination and computed tomography scan of case 1. A: Enhanced computed tomography image of BTPH shows a low density in the pancreatic head mass at 3.5 cm × 3.2 cm. The tumor displayed ill-defined borderline in calcified lesions; B: Shape and structure of BTPH. The tumor is an oval shape and some necrotic tissue existed inside the tumor; C: Wound surface area of the pancreas. Measuring wound surface area of the pancreas is 6.3 cm × 6.5 cm after the tumor removed; D: Illustration for operative repair with Roux-en-Y pancreaticojejunostomy is shown with proximal pancreatic end ligated and a stent is put into distal pancreatic resection. BTPH: Benign tumors of the pancreatic head.

Figure 2 B-ultrasonic examination and computed tomography scan of case 2. A: Enhanced computed tomography image image of BTPH shows oval-shaped lesions at approximately 4.2 cm in diameter with significantly uneven density around the enhanced loci; B: The uncinate process carcinoma of the pancreas is a solid mass with an uneven texture in area of 3.6 cm × 3.5 cm; C: The wound surface area of the pancreas is measured at 7.0 cm × 6.5 cm after the surgery; D: Illustration for wound repair with Roux-en-Y pancreaticojejunostomy. BTPH: Benign tumors of the pancreatic head.

Figure 3 B-ultrasonic examination and computed tomography scan of case 3. A: Enhanced computed tomography image of BTPH shows oval solid lesions measuring 3.3 cm in diameter in the uncinate process. BTPH had significantly strengthened density around the enhanced loci; B: The uncinate process carcinoma of the pancreas is solid texture with low density in area of 3.6 cm × 3.5 cm; C: The uncinate process carcinoma of pancreas is a solid mass with uneven texture in area of 3.2 cm × 3.5 cm; D: Pancreaticojejunostomy Roux-en-Y anastomosis shows wound surface area measuring 5.2 cm × 5.0 cm. BTPH: Benign tumors of the pancreatic head.

Figure 4 B-ultrasonic examination and computed tomography scan of case 4. A: Enhanced computed tomography image of BTPH Uncinate process of multilocular cystic placeholder measured at 4.3 cm in a diameter; B: The tumor mass is carefully isolated along its edge; C: The uncinate process of multilocular cystic placeholder detected at 4.5 cm × 4.8 cm; D: After the resection of pancreatic head tumor, the wound surface area of the pancreas measured at 7.2 cm × 6.1 cm. BTPH: Benign tumors of the pancreatic head.

Figure 5 Schematic sketch of some key steps.