Techniques of pancreatoduodenectomy and duodenum-preserving pancreatic head resection (DPPHR). (A) Classical Whipple procedure after resection and reconstruction with pancreaticojejunostomy, bilio-digestive anastomosis and gastrojejunostomy. (B) DPPHR according to Beger: Dissection of the pancreas above the portal vein, escavation of the pancreatic head and incision of the common bile duct. Reconstruction s accomplished by two pancreaticojejunostomies (corpus and pancreatic head). (C) DPPHR, Berne modification: Excavation of the pancreatic head and incision of the common bile duct without dissection of the pancreas above the portal vein. Reconstruction is accomplished by one single side-to-side pancreatcojejunostomy. (D) DPPHR, Frey modification: circumscripted excavation of the pancreatic head and longitudinal incision of the pancreatic duct. Reconstruction is accomplished by pancreaticojejunostomy.