Pancreaticoduodenectomy for benign disease

Ten cases of pancreaticoduodenectomy (PD) performed for benign disease are reported with all patients alive and well at an average of 7.5 years. A review of the English literature reveals that 52 patients have had a PD for benign disease in which a carcinoma had originally been suspected (incidence of 1%) with an overall surgical mortality of 9.6%. Three hundred and thirty-four cases of PD done for complications of pancreatitis have been reported with an overall mortality of 4.8%. On rare occasion, despite extensive preoperative evaluation, a patient will be explored with true uncertainty as to the diagnosis of a periampullary mass. Under these circumstances, it has been considered good surgical judgement to proceed with resection, considering that the lesion may be benign, as opposed to leaving behind an early resectable malignant lesion. Results of this review support this policy only in that if the PD is done for what turns out to be benign disease, the perioperative mortality is low, and an excellent long-term survival can be expected.