Short- and long-term outcomes of pancreatectomy with or without biliary tract and duodenum preservation for benign and borderline neoplasms

摘要

Objectives: The aim of this study was to compare short- and long-term outcomes of biliary tract and duodenum-preserving pancreatectomy (BT-DPP) versus non-conservative pancreatectomy (NCP). Patients and Methods: From 2008 to 2012, 39 of 259 patients underwent pancreatectomy for benign or borderline neoplasms. Patients were classified as BTDPP (n = 15) or NCP (n = 24). Data were prospectively collected and retrospectively analyzed on an intention-to-treat basis. Results: Both groups were comparable regarding demography, intra- and postoperative data (operative time, blood loss) and length of hospital stay. Overall complications occurred in 10 and 19 (p = 0.31), postpancreatectomy fistula in 2 and 4 (p = 0.6), biliary fistula in 3 and 1 (p = 0.15), and postpancreatectomy hemorrhage in 3 and 7 (p = 0.4) patients in the BT-DPP and NCP groups, respectively. One patient in the NCP group died. The median follow-up was 27 (4.4-56.5) and 23.4 (0.3-53) months in the BT-DPP and NCP groups, respectively. One BT-DPP patient had biliary stenosis treated endoscopically and 1 patient in the NCP group required surgery. The incidence of diabetes was equal. Conclusion: Our study shows that BT-DPP is feasible without an increase in morbidity compared with NCP. In the long term, BT-DPP was not associated with higher morbidity.