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Journal of Hepato-Biliary-Pancreatic Sciences

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01-01-2011 | Original article

Duodenum-preserving versus pylorus-preserving pancreatic head resection for benign and premalignant lesions

Authors: Sergio Pedrazzoli, Silvio Alen Canton, Cosimo Sperti

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 1/2011

Abstract

Background/purpose

Pylorus-preserving pancreaticoduodenectomy (PPPD) is the treatment of choice for benign or premalignant pancreatic head lesions. Duodenum-preserving pancreatic head resection (DPPHR) has been reported in only 132 patients. This study aimed to compare the long-term results of DPPHR and PPPD.

Methods

Patients who underwent DPPHR or PPPD for benign or borderline disease between 1991 and 2008 were followed up until December 2009 or their death. Endocrine and exocrine pancreatic functions were evaluated at their last follow-up.

Results

Twenty-seven patients underwent DPPHR (Group 1) and 37 PPPD (Group 2). They were followed for a mean of 100 and 135 months, respectively. Group 1 had a higher complication rate (81.5 vs. 40.5%) and pancreatic fistula rate (40.1 vs. 18.9%). Hospital mortality was 0 and 2.7%, respectively. Two patients died 3.3 and 97 months after DPPHR. Significantly more Group 2 patients needed medical treatment for benign cholangitis (P < 0.0001). Insulin-dependent diabetes mellitus was observed in six Group 1 and 15 Group 2 patients (P = 0.077). Ten Group 1 and 21 Group 2 patients are taking pancreatic enzymes (P = 0.003).

Conclusions

DPPHR for benign or premalignant lesions is a difficult procedure with a higher complication rate than PPPD, but was without mortality. Preserving the entire duodenum and a normal biliary tree allows better long-term results.

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Title: Duodenum-preserving versus pylorus-preserving pancreatic head resection for benign and premalignant lesions
Authors: Sergio Pedrazzoli
Silvio Alen Canton
Cosimo Sperti
Publication date: 01-01-2011
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 1/2011
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-010-0317-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Duodenum-preserving versus pylorus-preserving pancreatic head resection for benign and premalignant lesions

Abstract

Background/purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background/purpose

Methods

Results

Conclusions

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