What should be the standard operation in chronic pancreatitis: Whipple or duodenum-preserving pancreatic head resection?
Surgical options in the treatment of chronic pancreatitis have undergone both development and controversial discussion in the past decades. Operations such as the classical and pylorus-preserving Whipple resections are more and more being replaced by operations such as the duodenum-preserving pancreatic head resection, which preserves extrapancreatic organs like the stomach, the duodenum and the extrapancreatic bile duct. The latter operation preserves a normal food passage and glucose metabolism after surgical intervention. In addition, the duodenum-preserving pancreatic head resection provides long-term pain relief and reduction in up to 90% of chronic pancreatitis patients, as well as a general improvement in quality of life. This article will summarize and compare the surgical options in the treatment of chronic pancreatitis and will provide arguments why the duodenum-preserving pancreatic head resection should replace the classical and the pylorus-preserving Whipple resections as the standard surgical procedure used to treat chronic pancreatitis-related complications.
Berberat
P O
PO
Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, Switzerland.
Friess
H
H
Martignoni
M E
ME
Tempia
A
A
Büchler
M W
MW
D002908:Chronic Disease; D004322:Drainage; D004386:Duodenum / Q000601:surgery*; D006801:Humans; D010180:Pancreatectomy / Q000379:methods / Q000592:standards*; D016577:Pancreaticoduodenectomy / Q000379:methods / Q000592:standards*; D010195:Pancreatitis / Q000601:surgery*