Pylorus-preserving pancreatoduodenectomy. Experience in 20 patients.
Twenty patients underwent a pylorus-preserving pancreatoduodenectomy for benign or malignant periampullary and pancreatic disease. Eighteen patients had a partial and two patients a total pancreatectomy. There were 19 elective and 1 emergency operations. Post-operative mortality was 4% (1/20 patients) and the median follow up was 31 months (range, 15-75 months), during which period 8 patients with a malignant disease died. Pylorus-preserving pancreatoduodenectomy did not compromise survival in ampullary cancer. One patient developed a marginal ulcer during the study period and one of twelve patients, examined by technetium scintigraphy (done more than 3 months after the procedure), had delayed gastric emptying. Two patients presented with a gastric retention as the first sign of recurrent pancreatic cancer. The result of the operation was judged as excellent in 7 patients, good in 8 and as bad in only 2 of the 17 patients who survived more than 6 months. Body weight was studied in 15 patients surviving more than one year after operation; five patients had gained weight, two had lost weight and in 8 there was no difference. Pylorus-preserving pancreatoduodenectomy seems to be a valuable alternative in the treatment of patients with benign and selected malignant pancreaticobiliary disease.
Lerut
J
J
Department of Visceral and Transplantation Surgery, Inselspital, University Hospital, Berne, Switzerland.
Luder
P J
PJ
Krähenbühl
L
L
Gertsch
P H
PH
Blumgart
L H
LH
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery; D010437:Peptic Ulcer / Q000209:etiology; D011184:Postoperative Period; D011708:Pylorus