Pylorus-preserving duodenopancreatectomy: long-term complications and comparison with the Whipple procedure.
We have performed 33 pylorus-preserving duodenopancreatectomies. Twenty patients presented with severe chronic pancreatitis and 13 with periampullary adenocarcinoma. We have no postoperative mortality and a 24% rate of morbidity. Complications include anastomotic leaks (2), surgical bleeding (1), anastomotic ulceration (1), and others (4). We have complete follow-up for all cases. In the tumor group, 8 (62%) patients are alive with a mean survival time of 20 months (range: 2-46). In the pancreatitis series, all patients are alive after a mean of 34 months (range: 4-66). We have observed 5 cases (15%) of anastomotic ulcerations responsible for stenosis (2) and acute perforation with peritonitis (2) occurring after a mean interval of 18 months. Four cases have been confirmed histologically after resection. The short- and long-term beneficial effects of the pylorus-preserving operation on patient well-being and nutritional status were confirmed and compared with the results achieved after a Whipple procedure performed in a series of 18 consecutive patients.
Morel
P
P
Department of Surgery, University Hospital, Geneva, Switzerland.
Mathey
P
P
Corboud
H
H
Huber
O
O
Egeli
R A
RA
Rohner
A
A
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D014670:Ampulla of Vater; D002908:Chronic Disease; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications; D011708:Pylorus / Q000601:surgery*; D013997:Time Factors