Beger procedure

A duodenal-preserving pancreatic head resection (DPPHR) technique was described by Beger in 1980 for chronic pancreatitis in an effort to decrease the morbidity of pancreatic head resection. In DPPHR, the pancreas neck is transected (A), followed by a subtotal resection of the head. A rim of pancreatic parenchyma along the duodenal wall, which contains the arcade of duodenal arterial blood supply, is preserved (B). A Roux-en-Y limb of jejunum is then used to create a pancreaticojejunostomy (C). DPPHR is an alternative to pancreaticoduodenectomy in patients with a small-diameter main pancreatic duct (<6 to 7 mm) and head-dominant chronic pancreatitis.