The Saudi Journal of Gastroenterology (Jan 2004)
Outcome of pancreaticoduodenectomy: Comparing the classic whipple with pyloric preservation
Abstract
Background: The majority of patients presenting with periampullary neoplasms are operative candidates and are treated surgically. Aim of the study: To assess the complications, morbidity, mortality and 2-year survival rates, and safety of pancreaticoduodenectomy for periampullary carcinomas in a non-oncology surgical set-up. Patients and methods: Records of 23 patients underwent pancreaticoduodenectomy for periampullary cancers between July 1995 and April 2001 in Guilan, Iran, were reviewed. Results: Among 23 consecutive patients who underwent pancreaticoduodenectomy, 16 were men and 7 were women, and the mean age was 58 +/-10.2years. All the patients had a malignant neoplasm. Mean operative time was 7.3 hours. The surgical procedure was pylorus-preserving pancreaticoduodenectomy (PPPD) in 65%. The median intraoperative blood loss was 625 ml and no transfusion was required. There was no intraoperative mortality, and the overall 30-day postoperative mortality rate was 4.5%. Delayed gastric emptying was the most common postoperative complication. The 2-year survival rates for periampullary cancers were 93% in PPPD and 62.5% in classic Whipple procedure. Conclusion: Pancreaticoduodenectomy for periampullary tumors remains a formidable procedure in our set-up. It can be performed safely with low mortality and morbidity rates
