A comparison of the long-term functional outcomes of standard pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy.
OBJECTIVE
We compared the long-term functional outcomes of standard pancreatoduodenectomy (SPD) and pylorus-preserving pancreatoduodenectomy (PPPD) patients.


METHODS
The subjects were 67 patients who underwent SPD (23) or PPPD (44) and who survived more than 3 years. General nutritional status, pancreatic functions, gastrointestinal (GI) symptoms, and quality of life (QOL) were assessed.


RESULTS
Postoperative relative body weights to preoperative body weight in the SPD group were generally lower, however, no significant difference was observed throughout the postoperative period, except at 6 postoperative months. Steatorrhea developed in 3 (13.0%) of the 23 SPD and in 6 (13.6%) of the 44 PPPD patients during the 3-year follow-up (p > 0.05). IFG or DM newly developed in 2 (10.5%) of the 19 SPD and in 5 (13.9%) of the 36 PPPD patients during the 3-year follow-up (p > 0.05). Symptoms such as flatus, diarrhea and fatigue were more frequently observed in SPD patients. The general health status/QOL score of the PPPD group (75.5) was somewhat higher than that of the SPD group (65.4) (p > 0.05).


CONCLUSIONS
The long-term functional outcomes of SPD and PPPD patients were generally comparable. However, PPPD was more favorable than SPD in terms of an earlier postoperative recovery and reduced rates of GI symptoms such as flatus and diarrhea.
Han
Sung-Sik
SS
Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
Kim
Sun-Whe
SW
Jang
Jin-Young
JY
Park
Yong-Hyun
YH
D000368:Aged; D001835:Body Weight; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D052756:Nutritional Sciences; D010179:Pancreas; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications; D011708:Pylorus / Q000473:pathology*; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome