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Comparison of Results between Pylorus-Preserving Pancreaticoduodenectomy and Subtotal Stomach-Preserving Pancreaticoduodenectomy: Report at a Single Cancer Institute


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Title: Comparison of Results between Pylorus-Preserving Pancreaticoduodenectomy and Subtotal Stomach-Preserving Pancreaticoduodenectomy: Report at a Single Cancer Institute
Authors: Nanashima, Atsushi / Abo, Takafumi / Sumida, Yorihisa / Tobinaga, Syuuichi / Nonaka, Takashi / Takeshita, Hiroaki / Hidaka, Shigekazu / Sawai, Terumitsu / Yasutake, Toru / Nagayasu, Takeshi
Issue Date: Jul-2013
Publisher: H.G.E. Update Medical Publishing Ltd.
Citation: Hepato-Gastroenterology, 60(125), pp.1182-1188; 2013
Abstract: Background/Aims: Pylorus-preserving pancreaticoduodenectomy (PPPD) has the advantage of achieving good nutritional status postoperatively, but delayed gastric empty (DGE) is a frequent complication leading to a longer fasting period. Subtotal stomachpreserving pancreaticoduodenectomy (SSPPD) is an alternative option to preserve nutritional status and shorten the fasting period. We retrospectively compared clinical results between PPPD and SSPPD. Methodology: PPPD was performed in 28 patients and SSPPD in 27, between 2000 and 2009. Results: Pancreatic carcinoma was more frequent in the SSPPD group (p = 0.041). Operating time was longer in the SSPPD group (610 min) than in the PPPD group (540 min; p = 0.031). Blood loss was greater in the SSPPD group (1810 mL) than in the PPPD group (1306 mL; p = 0.048). Period of NG intubation and fasting period were shorter in the SSPPD group (6 days and 9 days, respectively) compared to the PPPD group (15 days and 19 days, respectively; p <0.01 each). Severe DGE was 7% in the SSPPD group and 46% in the PPPD group (p <0.01). Postoperative complications and nutritional status in the early period did not differ between groups, although incidence of fatty liver was higher in the SSPPD group (78%) than in the PPPD group (25%; p <0.01). Conclusions: SSPPD is a useful alternative for pancreaticoduodenectomy. Further prospective studies with longer follow-up are warranted to clarify the superiority and problems associated with this procedure.
Keywords: Delayed gastric empty / Nutritional status / Pancreaticoduodenectomy
URI: http://hdl.handle.net/10069/33981
ISSN: 01726390
DOI: 10.5754/hge11045
Rights: © H.G.E. Update Medical Publishing S.A.
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/33981

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