title: Pancreaticoduodenectomy versus duodenum-preserving pancreatic head resection for the treatment of chronic pancreatitis.
abstract: OBJECTIVE
  The objective of this study was to assess the efficacy and safety of pancreaticoduodenectomy (PD) and duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis (CP).
  
  
  METHODS
  The 123 patients with CP who underwent pancreatic head resection between January 2004 and June 2009 were retrospectively analyzed. The preoperative variables, operative data, postoperative complications, and follow-up information were examined.
  
  
  RESULTS
  There were no significant differences in clinical and morphological characteristics, pain relief, and jaundice status between the PD and DPPHR groups. The duration of operation was shorter (251.8 [SD, 43.1] vs 324.5 [SD, 41.4] minutes, P < 0.001), blood loss was less (464.4 [SD, 203.6] vs 646.5 [SD, 242.9] mL, P < 0.001), and overall postoperative morbidity was lower (3% vs 19%, P = 0.006) in DPPHR group. The duration of hospital stay was also significantly different (9.9 [SD, 1.8] vs 13.7 [SD, 2.8] days, P < 0.001). Most functional and symptom scales revealed a better quality of life in DPPHR group. The proportion of patients with exocrine and endocrine insufficiency was higher in PD group as compared with DPPHR group.
  
  
  CONCLUSIONS
  Both procedures are equally effective in pain relief, but DPPHR is superior to PD in operative data, postoperative morbidity, improving quality of life, and preservation of exocrine and endocrine function.
authors.affiliation: Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Zhenjiang
authors.initials: Z
authors.lastname: Zheng
authors.forename: Guangming
authors.initials: G
authors.lastname: Xiang
authors.forename: Chunlu
authors.initials: C
authors.lastname: Tan
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Baowang
authors.initials: B
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Gong
authors.forename: Gang
authors.initials: G
authors.lastname: Mai
authors.forename: Xubao
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D004386:Duodenum / Q000601:surgery*; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000601:surgery; D010179:Pancreas / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome