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Pylorus-Resecting Pancreaticoduodenectomy

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Innovation of Diagnosis and Treatment for Pancreatic Cancer

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Abstract

Delayed gastric emptying (DGE) after pancreaticoduodenectomy is a persistent and frustrating complication. Moreover, it results in a prolonged length of stay that contributes to increase hospital costs and to decrease quality of life. Pylorus-resecting pancreaticoduodenectomy (PrPD) was designed as a new surgical procedure for periampullary neoplasms to reduce the frequency of DGE compared to pylorus-preserving pancreaticoduodenectomy (PpPD). In PrPD, the stomach is divided just adjacent the pylorus ring and the nearly total stomach more than 95% is preserved. There are two RCTs and five retrospective studies which compared PpPD to PrPD based on DGE defined by the international study group of pancreatic surgery. Two meta-analyses comparing PrPD with PpPD reported that PrPD resulted in a significant reduction of the incidence of DGE compared to PpPD. Moreover, it has been reported that PrPD offers similar long-term outcomes with PpPD regarding QOL, nutritional status, and late complications. Further studies are required to clarify the long-term QOL and/or nutritional status resulting after PrPD. However, PrPD is one of the procedures that may be recommended for treatment of periampullary neoplasms including pancreatic cancer.

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Authors and Affiliations

  1. Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Manabu Kawai M.D. & Hiroki Yamaue M.D.

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  1. Manabu Kawai M.D.
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  2. Hiroki Yamaue M.D.
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Correspondence to Manabu Kawai M.D. .

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  1. Second Department of Surgery, Wakyama Medical University, Wakayama, Japan

    Hiroki Yamaue

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Kawai, M., Yamaue, H. (2017). Pylorus-Resecting Pancreaticoduodenectomy. In: Yamaue, H. (eds) Innovation of Diagnosis and Treatment for Pancreatic Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-2486-3_7

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  • DOI: https://doi.org/10.1007/978-981-10-2486-3_7

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