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HPB Surgery
Volume 4 (1991), Issue 2, Pages 109-119
http://dx.doi.org/10.1155/1991/52435
Review Article

Pylorus-Preserving Pancreatoduodenectomy. Experience in 20 Patients

Department of Visceral and Transplantation Surgery, Inselspital, University Hospital, Berne 3010, Switzerland

Received 13 December 1990

Copyright © 1991 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Twenty patients underwent a pylorus-preserving pancreatoduodenectomy for benign or malignant periampullary and pancreatic disease. Eighteen patients had a partial and two patients a total pancreatectomy. There were 19 elective and 1 emergency operations.

Post-operative mortality was 4% (1/20 patients) and the median follow up was 31 months (range, 15– 75 months), during which period 8 patients with a malignant disease died.

Pylorus-preserving pancreatoduodenectomy did not compromise survival in ampullary cancer.

One patient developed a marginal ulcer during the study period and one of twelve patients, examined by technetium scintigraphy (done more than 3 months after the procedure), had delayed gastric emptying. Two patients presented with a gastric retention as the first sign of recurrent pancreatic cancer.

The result of the operation was judged as excellent in 7 patients, good in 8 and as bad in only 2 of the 17 patients who survived more than 6 months . Body weight was studied in 15 patients surviving more than one year after operation; five patients had gained weight, two had lost weight and in 8 there was no difference.

Pylorus-preserving pancreatoduodenectomy seems to be a valuable alternative in the treatment of patients with benign and selected malignant pancreaticobiliary disease.