Pylorus Preserving Pancreaticoduodenectomy Versus Standard Whipple Procedure

作者：Khe T. C. Tran, Hans G. Smeenk, Casper H.J. van Eijck, Geert Kazemier, Wim C.J. Hop, Jan Willem G. Greve, Onno T. Terpstra, Jan A. Zijlstra, Piet Klinkert, Hans J. Jeekel · 发表于：Annals of Surgery · 年份：2004 · DOI：10.1097/01.sla.0000143248.71964.29 · 被引用次数：419 · 研究领域：Pancreatic and Hepatic Oncology Research、Gastric Cancer Management and Outcomes、Gastrointestinal Tumor Research and Treatment

In Brief Objective: A prospective randomized multicenter study was performed to assess whether the results of pylorus-preserving pancreaticoduodenectomy (PPPD) equal those of the standard Whipple (SW) operation, especially with respect to duration of surgery, blood loss, hospital stay, delayed gastric emptying (DGE), and survival. Summary Background Data: PPPD has been associated with a higher incidence of delayed gastric emptying, resulting in a prolonged period of postoperative nasogastric suctioning. Another criticism of the pylorus-preserving pancreaticoduodenectomy for patients with a malignancy is the radicalness of the resection. On the other hand, PPPD might be associated with a shorter operation time and less blood loss. Methods: A prospective randomized multicenter study was performed in a nonselected series of 170 consecutive patients. All patients with suspicion of pancreatic or periampullary tumor were included and randomized for a SW or a PPPD resection. Data concerning patients’ demographics, intraoperative and histologic findings, as well as postoperative mortality, morbidity, and follow-up up to 115 months after discharge, were analyzed. Results: There were no significant differences noted in age, sex distribution, tumor localization, and staging. There were no differences in median blood loss and duration of operation between the 2 techniques. DGE was observed equally in the 2 groups. There was only a marginal difference in postoperative weight loss in favor...