| Objective: To discuss the anatomic basis of modified pancreatoduodenectomy for the preservation of ascending portion of duodenum compared with traditional pancreatoduodenectomy. Backgrounds: Pancreatoduodenectomy is widely applied in pancreatic cancer and carcinoma of ampulla, but periampullary neoplasm is one of the most malignant tumor with special position. Surgical methods is variable at present, but have brought more serious complications. Methods: Describe in details the anatomy of modified pancreatoduodenectomy for the preservation of ascending portion of duodenum, then by retrospectively analyzing 45 cases of ascending portion preserving operation in 133 cases of pancreatoduodenectomy in our hospital in recent years. The key points of this surgical procedure and its advantages were described. Results: Compared with traditional surgical procedure ,the preservation of the ascending portion group was less in the aspect of operation time and ratio of transfusion, and was shorter in the convalescence of gut and hospital stay. Conclusions: 1, the anatomic rationale is consistent with the clinical effect; and it proved that this surgical procedure is feasible; 2, this surgical procedure avoids the harmful extensive dissection and shortens the operation time with lymph node dissection unaffected. It is helpful for the convalescence of the patients and the improvement of the patients' living quality.
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