Skip to main content

Pylorus-preserving pancreatoduodenectomy for cancer treatment: Surgical procedure, indications, and analysis of outcomes


Factors determining the prognosis of cancer of the pancreatic head were analyzed in 100 patients who had undergone surgical treatment. So as to clarify the indications for pylorus-preserving pancreatoduodenectomy (PPPD), the prognosis was compared in two sets of such patients, 25 who had undergone PPPD and 25 who had undergone the Whipple procedure. Of these 50 patients, 20 (40%) also underwent portal vein resection and 29 (58%) were found to have lymph node metastasis. Curative resection was achieved in 33 of these 50 patients (66%) and the 5-year survival rate after the curative resection (42.0%) was significantly higher in these patients that in those given a non-curative resection (P <0.01). Further, the prognosis was better for patients who did not require a portal vein excision than for those who did (P<0.01), and for patients who showed no lymph node metastasis than for those with metastasis (P<0.01). The 5-year survival rate did not differ significantly between the PPPD group and the Whipple procedure group. These results indicate that PPPD can also be a useful procedure for treating malignant diseases.

This is a preview of subscription content, access via your institution.


  1. Fortner JG (1989) “Radical” abdominal cancer surgery: Current state and future course. Jpn J Surg 19:503–509

    CAS  PubMed  Google Scholar 

  2. Fortner JG (1973) Regional resection of the pancreas: A new surgical approach. Surgery 73:307–320

    CAS  PubMed  Google Scholar 

  3. Nagakawa T, Kurachi M, Konishi K, et al (1982) Translateral retroperitoneal approach in radical surgery for pancreatic carcinoma. Jpn J Surg 12:229–233

    CAS  PubMed  Google Scholar 

  4. Traverso, LW, Longmire WP (1978) Preservation of the pylorus in pancreatoduodenectomy. Surg Gynecol Obstet 146:956–962

    Google Scholar 

  5. Japan Pancreas Society (1986) General rules for surgery and the pathological study of cancers of the pancreas, 3rd edn (in Japanese with English abstract). Kanehara, Tokyo

    Google Scholar 

  6. Takada T (1993) Pylorus-preserving pancreatoduodenectomy: Its technique and indications. Hepatogastroenterology 40:422–425

    CAS  PubMed  Google Scholar 

  7. Sharp KW, Ross CB, Halter SA, et al (1989) Pancreatoduo-denectomy with pyloric preservation for carcinoma of the head of the pancreas. A cautionary note. Surgery 105:645–653

    CAS  PubMed  Google Scholar 

  8. Nagasako T, Hanyu F, Imaizumi T, et al (1990) Criteria for pylorus-preserving pancreatoduodenectomy in patients with a periampullary carcinoma — histopathological study of 245 surgically resected cases (in Japanese with English abstract). Jpn J Gastroenterol Surg 23:2532–2537

    Google Scholar 

  9. Yamamoto M, Saito Y, Oohashi S, Ishida H (1993) General rules for cancer of pancreas from standpoint of the report of the Pancreatic Cancer Registry (in Japanese). Tan to Sui (J Bil Panc) 14:935–941

    Google Scholar 

  10. Grace PA, Pitt HA, Longmire WP (1986) Pancreatoduodenectomy with pylorus preservation for adenocarcinoma of the head of the pancreas. Surg Gynecol Obstet 160:1–4

    Google Scholar 

Download references

Author information

Authors and Affiliations


About this article

Cite this article

Takada, T., Yasuda, H., Uchiyama, K. et al. Pylorus-preserving pancreatoduodenectomy for cancer treatment: Surgical procedure, indications, and analysis of outcomes. J Hep Bil Pancr Surg 1, 367–371 (1994).

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI:

Key words

  • pylorus-preserving pancreatoduodenectomy
  • pancreatic cancer
  • Whipple procedure
  • pancreatectomy