Organ-preserving surgery for benign lesions and low-grade malignancies of the pancreatic head: a matched case-control study.
OBJECTIVE
To compare the postoperative results of various preservative surgery (PS) techniques with those of two types of pancreatoduodenectomy (PD).


METHODS
The subjects of this study were 65 patients treated surgically for chronic pancreatitis, or benign or borderline tumors. We defined PS as any of the following: duodenum-preserving pancreatic head resection (DPPHR), uncinatectomy (UC), and cystic tumor enucleation (EN). The two types of PD were Whipple pancreatoduodenectomy (WPD) and pylorus-preserving pancreatoduodenectomy (PPPD).


RESULTS
Benign lesions were treated with PD in 41 patients and PS in 24 patients. Whipple pancreatoduodenectomy was performed in 17 patients, PPPD in 24, DPPHR in 20, EN in 3, and UC in 1. The main indication for surgery was chronic pancreatitis (66%). Delayed gastric emptying (DGE) was seen in 41% of patients in the PD group but none in the PS group (P = 0.04). However, there were no differences between the two groups in the incidence of pancreatic fistulas or other complications. Reoperation was required in five of the PD patients, but none of the PS patients.


CONCLUSIONS
Surgical techniques for preserving pancreatic tissue are effective for carefully selected patients with benign pancreatic disorders.
Busquets
Juli
J
Department of General and Digestive Surgery, Bellvitge University Hospital, C/Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona, Spain.
Fabregat
Juan
J
Borobia
Francisco G
FG
Jorba
Rosa
R
Valls
Carlos
C
Serrano
Teresa
T
Ramos
Emilio
E
Pelaez
Nuria
N
Rafecas
Antonio
A
D016022:Case-Control Studies; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010185:Pancreatic Fistula; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012086:Reoperation; D016896:Treatment Outcome