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Duodenum-preserving pancreatic head resection: Long-term results
M W Büchler1, H Friess, R Bittner
1Department of Surgery and Gastroenterology, University of Ulm, Ulm, Germany.
Summary
Duodenum-preserving pancreatic head resection (DPPHR) offers effective surgical treatment for chronic pancreatitis. This procedure significantly reduces pain and improves work capacity in patients with pancreatic head lesions.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pancreatic Surgery
Background:
- Chronic pancreatitis often presents with inflammatory enlargement of the pancreatic head, leading to complications.
- Surgical intervention is sometimes necessary to manage these complex cases and alleviate symptoms.
Purpose of the Study:
- To prospectively analyze the early and late outcomes of duodenum-preserving pancreatic head resection (DPPHR) in patients with chronic pancreatitis.
- To evaluate the efficacy of DPPHR in decompressing the common bile duct, pancreatic duct, duodenum, and retropancreatic vessels.
Main Methods:
- Prospective analysis of 298 patients undergoing DPPHR for chronic pancreatitis.
- Evaluation of early postoperative outcomes including mortality and morbidity.
- Long-term follow-up (1-22 years, median 6 years) assessing late mortality, pain relief, and return to work.
Main Results:
- In-hospital mortality was 1%, with a 28.5% postoperative morbidity rate and 5.7% repeat laparotomy rate.
- Early postoperative diabetes mellitus developed in 2% of patients.
- Late mortality was 8.9% after a median follow-up of 6 years; 88% experienced pain relief, and 63% returned to work.
Conclusions:
- DPPHR is a viable surgical option for chronic pancreatitis when the primary issue is in the pancreatic head.
- The procedure demonstrates favorable long-term results regarding pain management and functional recovery.