Pancreaticoduodenectomy for benign disease

Area of Science:

• Gastroenterology
• Surgical Oncology
• Hepatobiliary Surgery

Background:

• Pancreaticoduodenectomy (PD) is a complex procedure often indicated for periampullary masses.
• Benign conditions can mimic malignant presentations, leading to diagnostic uncertainty.
• Previous literature reports variable outcomes for PD in benign versus malignant cases.

Purpose of the Study:

• To evaluate the outcomes of pancreaticoduodenectomy (PD) performed for histologically benign disease.
• To assess the safety and long-term survival following PD when initially indicated for suspected malignancy.
• To provide evidence supporting surgical resection in cases of diagnostic uncertainty for periampullary masses.

Main Methods:

• Retrospective review of ten cases of PD for benign disease.
• Comprehensive literature review of PD cases for benign disease and pancreatitis complications.
• Analysis of surgical mortality and long-term patient survival.

Main Results:

• All ten patients undergoing PD for benign disease were alive and well at an average of 7.5 years post-surgery.
• Literature review identified 52 PD cases for benign disease (suspected carcinoma) with 9.6% mortality.
• PD for pancreatitis complications had a 4.8% mortality rate.

Conclusions:

• PD for benign disease demonstrates low perioperative mortality and excellent long-term survival.
• Resection is justifiable in cases of diagnostic uncertainty for periampullary masses to avoid missing resectable malignancies.
• This approach ensures favorable outcomes when the resected lesion is ultimately found to be benign.