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Updated: Aug 10, 2026
Laparoscopic Pancreatoduodenectomy With Modified Blumgart Pancreaticojejunostomy
Published on: June 17, 2018
Intermediate results of extended pancreaticoduodenectomy. Verona experience
C Iacono1, E Facci, L Bortolasi
1Department of Surgery, Division of General Surgery C, University of Verona, Italy.
Background:
Extended pancreaticoduodenectomy (EPD) with retroperitoneal lymphatic, neural, and connective clearance has been proposed to improve survival in patients with carcinomas of the head of the pancreas. The open questions are: does EPD allow better staging of the tumor? Does it reduce local recurrences? And does it improve survival?
Method:
We treated 26 patients by EPD between January 1994 and September 1996. Eighteen patients had pancreatic ductal carcinoma, 7, periampullary carcinoma; and 1, intraductal papillary mucinous carcinoma.
Results:
The pancreatic cancers were International Union against Cancer (UICC) stage I in 3 patients, stage III in 14, and stage IV in 1. Two patients with stage III disease would have been considered as having stage I without EPD. Pancreatic cancer and periampullary carcinoma patients had a 3-year actuarial survival of 32% and 86%, respectively. At a mean follow-up time of 22.5 months (range, 6-39 months), 3 pancreatic cancer patients (16.6%) had loco-regional recurrences, 6 patients (33%) had distant metastases, and 1 (5.5%) had distant and loco-regional recurrences. Only 1 of 7 patients with periampullary carcinoma had distant metastasis 20 months after resection.
Conclusion:
EPD seems to decrease the rate of local recurrences and allows more correct staging. The intermediate survival results are encouraging but a definitive conclusion awaits longer follow-up.
