In pylorus preserving Pancreatoduodenectomy following is not resected –
**Core Concept**
In a pylorus-preserving Pancreatoduodenectomy (PPPD), the surgical procedure involves the resection of the pancreatic head, duodenum, bile duct, and gallbladder, while preserving the pylorus and part of the duodenum. The primary goal is to remove the tumor or diseased portion while preserving the pylorus and the duodenum's function.
**Why the Correct Answer is Right**
The correct answer is not resected because the pylorus is preserved in this surgical procedure. The pylorus is the region of the stomach that connects the stomach to the duodenum, and preserving it helps maintain gastrointestinal continuity and function. The pylorus is not affected by the tumor or disease process in the pancreatic head and is therefore not resected.
**Why Each Wrong Option is Incorrect**
**Option A:** The bile duct is typically resected in a PPPD, as the tumor or disease process often involves the bile duct, and resection is necessary to ensure complete removal of the disease.
**Option B:** The duodenum is partially resected in a PPPD, as the procedure involves removing the duodenum's second and third portions.
**Option C:** The gallbladder is typically removed in a PPPD, as it is often involved in the disease process and is usually removed to ensure complete removal of the tumor or disease.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that the primary goal of a PPPD is to remove the tumor or diseased portion of the pancreas and bile duct while preserving the pylorus and maintaining gastrointestinal continuity.
**Correct Answer:** D.