Randomized clinical trial of pylorus-preserving duodenopancreatectomy versus classical Whipple resection—long term results
- 30 March 2005
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 92 (5), 547-556
- https://doi.org/10.1002/bjs.4881
Abstract
Background: It is not known whether pylorus-preserving duodenopancreatectomy is as effective as the classical Whipple procedure in the resection of pancreatic and periampullary tumours. A prospective randomized trial was undertaken to compare the results of the two procedures. Methods: Clinical data, histological findings, short-term results, survival and quality of life of all patients having surgery for suspected pancreatic or periampullary cancer between June 1996 and September 2001 were analysed. Results: Two hundred and fourteen patients were randomized to undergo either a standard or a pylorus-preserving Whipple resection. After exclusion of 84 patients on the basis of intraoperative findings, 130 patients (66 standard Whipple operation and 64 pylorus-preserving resection) were entered into the trial. Of these, 110 patients with proven adenocarcinoma (57 standard Whipple and 53 pylorus-preserving resection) were analysed for long-term survival and quality of life. There was no difference in perioperative morbidity. Long-term survival, quality of life and weight gain were identical after a median follow-up of 63·1 (range 4–93) months. At 6 months, capacity to work was better after the pylorus-preserving procedure (77 versus 56 per cent; P = 0·019). Conclusion: Both procedures were equally effective for the treatment of pancreatic and periampullary cancer. Pylorus-preserving Whipple resection offers some minor advantages in the early postoperative period, but not in the long term.This publication has 30 references indexed in Scilit:
- Randomized prospective trial of pylorus-preserving vs. classic duodenopancreatectomy (whipple procedure): initial clinical resultsJournal of Gastrointestinal Surgery, 2000
- Pancreatic fistula after pancreatic head resectionBritish Journal of Surgery, 2000
- Prospective randomized comparison between pylorus-preserving and standard pancreaticoduodenectomyBritish Journal of Surgery, 1999
- Onkologische Standardchirurgie des PankreaskarzinomsVisceral Medicine, 1998
- Die Wertigkeit der pyloruserhaltenden partiellen Duodenopankreatektomie beim duktalen PankreascarcinomDer Chirurg, 1997
- Delayed Gastric Emptying After Standard Pancreaticoduodenectomy Versus Pylorus-Preserving Pancreaticoduodenectomy: An analysis of 200 Consecutive PatientsJournal of the American College of Surgeons, 1997
- Six Hundred Fifty Consecutive Pancreaticoduodenectomies in the 1990sAnnals of Surgery, 1997
- Improving the Quality of Reporting of Randomized Controlled TrialsJAMA, 1996
- Randomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving whipple in chronic pancreatitisThe American Journal of Surgery, 1995
- Hat die Pyloruserhaltung bei der Pankreatoduodenektomie wegen periampull ren Karzinoms einen Stellenwert?Langenbecks Archiv für Chirurgie, 1994