Pylorus-preserving Kausch-Whipple resection: the successor of the classical Kausch-Whipple in chronic pancreatitis.
Chronic pancreatitis can be a debilitating disease. Resection for complicated disease and in those patients with intractable pain is a major component of therapy. There are potentially important physiological advantages with the pylorus preserving Kausch-Whipple (P-KW) compared to the standard Kausch-Whipple (KW) resection but further prospective studies are required to show this unequivocally. The Beger's operation also represents a significant theoretical advance. Indeed it permits resection in a proportion in whom a PP-KW or KW would not be possible technically because of severe fibrosis around the intra-pancreatic portal venous system. Although we have adopted the Beger's operation on our unit, large comparative studies are required against the KW and PP-KW procedures to properly establish its value. The hidden malignancy is an important issue, which undermines the routine use of the Beger's operation.
Slavin
J
J
Department of Surgery, University of Liverpool, Royal Liverpool University Hospital.
Ghaneh
P
P
Sutton
R
R
Neoptolemos
J P
JP
D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery*; D011708:Pylorus / Q000601:surgery*; D016896:Treatment Outcome