Comparison of Postoperative Bleeding and Delayed Gastric Emptying after the Whipple Surgery in Two Methods of Classic and Pylorus-Preserving in Patients Undergone Pancreaticoduodenectomy; A 5-Year Survey

Abstract

Background: Despite the high use of pancreaticoduodenectomy in the treatment of pancreatic cancers of the head, and the introduction of various surgical techniques, few studies have been done to investigate the complications and consequences of new surgery methods, especially pylorus-preserving pancreaticoduodenectomy (PPPD). Therefore, the aim of this study was to compare postoperative bleeding and delayed gastric emptying in patients undergoing Whipple surgery in classical and pylorus-preserving methods. Methods: In a prospective cohort study, 94 patients undergoing pancreaticoduodenectomy were studied, 53 patients with classical and 41 patients with PPPD method. The required information, including the type of surgery and its complications, were collected from patients' files, and contact with patients. Chi-square and t tests were used to compare the data. Findings: PPPD surgery had lower bleeding during surgery (801.34 versus 510.00 cc) (P < 0.001) and lower hospitalization duration (P = 0.027). However, there was no difference in postoperative bleeding (P < 0.050). Regarding the delay in gastric emptying during admission, although in the PPPD group was lower, but it was not statistically different (P = 0.255). Conclusion: In patients with surgical indication due to pancreatic cancers of the head, who are candidates for Whipple surgery, priority should be given to PPPD surgery, which reduces the need for blood during surgery, and the duration of hospitalization.

Keywords

• Pancreaticoduodenectomy
• Surgery
• Pylorus
• Gastric emptying
• Complications