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Pylorus preserving pancreaticoduodenectomy
A Ozenç1, A Ozdemir, S Bozoklu
1Hacettepe University, Medical School, Department of General Surgery, Ankara, Türkiye.
Acta Chirurgica Belgica
|July 1, 1993
Summary
Pylorus preserving pancreaticoduodenectomy (PPPD) offers a safer alternative for periampullary malignancies, showing no operative mortality and reduced complications compared to the standard Whipple procedure. Patients experienced significant weight regain and fewer long-term issues.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Periampullary malignancies require complex surgical resection.
- The standard Whipple procedure carries significant morbidity and mortality.
- Pylorus preservation in pancreaticoduodenectomy is an alternative surgical approach.
Purpose of the Study:
- To evaluate the safety and efficacy of pylorus preserving pancreaticoduodenectomy (PPPD) for periampullary malignancies.
- To compare outcomes of PPPD with the standard Whipple procedure.
- To assess complication rates, mortality, and long-term patient recovery after PPPD.
Main Methods:
- Retrospective analysis of 9 patients undergoing PPPD for periampullary malignancies.
- Diagnosis included ampullary, pancreatic, and duodenal carcinomas.
- Follow-up included assessment of mortality, morbidity, recurrence, metastasis, and weight recovery.
Main Results:
- No operative mortality observed in 9 PPPD cases.
- Morbidity rate was 44%, with complications including wound infections and intraabdominal abscess.
- No biliary or pancreatic leakage, gastrointestinal hemorrhage, or marginal ulceration occurred; 8/9 patients survived, with one recurrence detected.
- Patients regained 90% of lost weight within 4 months, with no dumping or delayed gastric emptying.
Conclusions:
- PPPD is technically feasible, faster, and associated with lower morbidity and mortality than the standard Whipple procedure.
- Pylorus preservation minimizes marginal ulceration and promotes better weight recovery.
- PPPD represents a viable and potentially superior surgical option for selected periampullary malignancy cases.