Total duodenopancreatectomy: the role of a multidisciplinary team approach in successful treatment. Case report

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Abstract

In order to identify and correct concomitant diseases all patients undergo a comprehensive examination before surgical treatment. Rare concomitant diseases include primary chronic adrenal insufficiency. This clinical case presents the total duodenopancreatectomy in a patient with primary chronic adrenal insufficiency. Available algorithms are not always suitable in the treatment of such patients after surgical interventions, especially long-term and extensive. It is necessary to focus on laboratory parameters and the clinical picture. An individual and multidisciplinary approach to the treatment of patients with comorbid pathologies is important.

About the authors

Alexey V. Shabunin

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: parlodel@mail.ru
ORCID iD: 0000-0002-4230-8033

акад. РАН, д-р мед. наук, проф., глав. врач ГБУЗ «ГКБ им. С.П. Боткина», зав. каф. хирургии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Alexandr S. Ametov

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: parlodel@mail.ru
ORCID iD: 0000-0002-7936-7619

д-р мед. наук, проф., науч. рук. отд-ния эндокринологии ГБУЗ «ГКБ им. С.П. Боткина», зав. каф. эндокринологии, зав. сетевой каф. ЮНЕСКО по теме «Биоэтика сахарного диабета как глобальная проблема» ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Mikhail M. Tavobilov

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: parlodel@mail.ru
ORCID iD: 0000-0003-0335-1204

д-р мед. наук, зав. отд-нием хирургии печени и поджелудочной железы ГБУЗ «ГКБ им. С.П. Боткина», проф. каф. хирургии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Evgeniya Yu. Pashkova

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: parlodel@mail.ru
ORCID iD: 0000-0003-1949-914X

канд. мед. наук, ст. науч. сотр., зав. отд-нием эндокринологии ГБУЗ «ГКБ им. С.П. Боткина», доц. каф. эндокринологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Alexey A. Karpov

Botkin City Clinical Hospital

Email: parlodel@mail.ru
ORCID iD: 0000-0002-5142-1302

канд. мед. наук, ст. науч. сотр., врач-хирург отд-ния хирургии печени и поджелудочной железы 

Russian Federation, Moscow

Aysa V. Lantsynova

Botkin City Clinical Hospital

Email: parlodel@mail.ru
ORCID iD: 0000-0002-9461-6791

мл. науч. сотр., врач-хирург отд-ния хирургии печени и поджелудочной железы 

Russian Federation, Moscow

Элина N. Венгерова

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: parlodel@mail.ru
ORCID iD: 0009-0009-8649-0656

врач-эндокринолог отд-ния эндокринологии ГБУЗ «ГКБ им. С.П. Боткина», каф. эндокринологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Anastasiya I. Polivtseva

Botkin City Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: parlodel@mail.ru
ORCID iD: 0009-0003-9427-8416

врач-ординатор отд-ния эндокринологии ГБУЗ «ГКБ им. С.П. Боткина», каф. эндокринологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Veronica B. Rumer

Botkin City Clinical Hospital

Email: parlodel@mail.ru
ORCID iD: 0000-0002-2803-470X

врач-рентгенолог отд. лучевой диагностики

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Computed tomogram of the abdominal organs with contrast enhancement dated 04.02.2023. The location of the largest cystic tumor is outlined in red.

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3. Fig. 2. Intraoperative photo: the patient’s stomach was preserved during total duodenopancreatectomy as modified by the Botkin Hospital.

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4. Fig. 3. Intraoperative photo: preserved splenic vessels in a patient during total duodenopancreatectomy as modified by the Botkin Hospital.

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5. Fig. 4. Glycemic profile overview.

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6. Fig. 5. Data from the patient's continuous glucose monitoring system during the perioperative period.

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