Duodenum-preserving pancreatic head resection vs. pancreatoduodenectomy for Benign lesions and low-grade malignancies of the pancreatic head

摘要

Background/Aims: To compare the postoperative results of duodenum-preserving pancreatic head resection (DPPHR) techniques with those of conventional pancreatoduodenectomy (PD). Methodology: We retrospectively reviewed the records of 58 patients who underwent DPPHR or PD at Jinhua central hospital between May 1998 and May 2011. Results: Eighteen patients underwent DPPHR (Group 1) and 40 conventional PD (Group 2). They were followed up for more than 6 months. Operation time in Group 1 was longer (290±18min vs. 269±14min, p=0.001). Estimated blood loss in Group 1 was more (633±88mL vs. 495±131mL, p=0.003). Intraoperative transfusion in Group 1 was more (533±88mL vs. 335±218mL, p=0.001). However, postoperative transfusion was less (141±162mL vs. 440±193mL, p=0.000). Group 1 had a lower short-term complication rate (16.67% vs. 50.0%, p=0.016) and long-term complication rate (11.11% vs. 45.0%, p=0.012). Hospital mortality of both groups were 0. Conclusions: DPPHR for benign or premalignant lesions is a difficult procedure, but with a lower complication rate than conventional PD. Preserving the entire duode-num and a normal biliary tree allows better short-term and long-term results. DPPHR will be suitable for only a small group of patients and should be performed by experienced surgeons.