Outcome of pancreaticoduodenectomy: comparing the classic Whipple with pyloric preservation.
BACKGROUND
The majority of patients presenting with periampullary neoplasms are operative candidates and are treated surgically.


OBJECTIVE
To assess the complications, morbidity, mortality and 2-year survival rates, and safety of pancreaticoduodenectomy for periampullary carcinomas in a non-oncology surgical set-up.


METHODS
Records of 23 patients underwent pancreaticoduodenectomy for periampullary cancers between July 1995 and April 2001 in Guilan, Iran, were reviewed.


RESULTS
Among 23 consecutive patients who underwent pancreaticoduodenectomy, 16 were men and 7 were women, and the mean age was 58 +/-10.2 years. All the patients had a malignant neoplasm. Mean operative time was 7.3 hours. The surgical procedure was pylorus-preserving pancreaticoduodenectomy (PPPD) in 65%. The median intraoperative blood loss was 625 ml and no transfusion was required. There was no intraoperative mortality, and the overall 30-day postoperative mortality rate was 4.5%. Delayed gastric emptying was the most common postoperative complication. The 2-year survival rates for periampullary cancers were 93% in PPPD and 62.5% in classic Whipple procedure.


CONCLUSIONS
Pancreaticoduodenectomy for periampullary tumors remains a formidable procedure in our set-up. It can be performed safely with low mortality and morbidity rates.
Guilan University of Medical Sciences, Rasht, Iran.
Mohammed Reza
MR
Kohsari
Hedayat
H
Riazi
Manzar Hussein
MH
Akbar