Duodenum-preserving versus pylorus-preserving pancreatic head resection for benign and premalignant lesions

Background/purpose Pylorus-preserving pancreaticoduodenectomy (PPPD) is the treatment of choice for benign or premalignant pancreatic head lesions. Duodenum-preserving pancreatic head resection (DPPHR) has been reported in only 132 patients. This study aimed to compare the long-term results of DPPHR...

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Bibliographic Details
Published in:Journal of hepato-biliary-pancreatic sciences 2011-01, Vol.18 (1), p.94-102
Main Authors: Pedrazzoli, Sergio, Canton, Silvio Alen, Sperti, Cosimo
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Duodenum - surgery
duodenum‐preserving pancreatic head resection
Female
Gastroenterology
Hepatology
Hospital Mortality
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Mortality
Original Article
Pancreas
Pancreatic Diseases - mortality
Pancreatic Diseases - surgery
pancreatic surgery
Pancreaticoduodenectomy - methods
Pancreaticoduodenectomy - mortality
Postoperative Complications - mortality
Precancerous Conditions - surgery
Pylorus - surgery
pylorus‐preserving pancreaticoduodenectomy
Surgical Oncology
Treatment Outcome
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Summary:Background/purpose Pylorus-preserving pancreaticoduodenectomy (PPPD) is the treatment of choice for benign or premalignant pancreatic head lesions. Duodenum-preserving pancreatic head resection (DPPHR) has been reported in only 132 patients. This study aimed to compare the long-term results of DPPHR and PPPD. Methods Patients who underwent DPPHR or PPPD for benign or borderline disease between 1991 and 2008 were followed up until December 2009 or their death. Endocrine and exocrine pancreatic functions were evaluated at their last follow-up. Results Twenty-seven patients underwent DPPHR (Group 1) and 37 PPPD (Group 2). They were followed for a mean of 100 and 135 months, respectively. Group 1 had a higher complication rate (81.5 vs. 40.5%) and pancreatic fistula rate (40.1 vs. 18.9%). Hospital mortality was 0 and 2.7%, respectively. Two patients died 3.3 and 97 months after DPPHR. Significantly more Group 2 patients needed medical treatment for benign cholangitis ( P  
ISSN:1868-6974
1868-6982
DOI:10.1007/s00534-010-0317-x