Clinical outcomes of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma depending on preservation or resection of pylorus

Yeon Jin Kim; Sang Hyun Shin; In Woong Han; Youngju Ryu; Naru Kim; Dong Wook Choi; Jin Seok Heo

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저자정보: Yeon Jin Kim (Sungkyunkwan University School of Medicine) Sang Hyun Shin (Sungkyunkwan University School of Medicine) In Woong Han (Sungkyunkwan University School of Medicine) Youngju Ryu (Sungkyunkwan University School of Medicine) Naru Kim (Sungkyunkwan University School of Medicine) Dong Wook Choi (Sungkyunkwan University School of Medicine) Jin Seok Heo (Sungkyunkwan University School of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제24권 제3호

발행연도: 2020.8

수록면: 269 - 276 (8page)

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Backgrounds/Aims: The comparative effectiveness of pylorus-resecting pancreaticoduodenectomy (PRPD) and pylorus-preserving pancreaticoduodenectomy (PPPD) in pancreatic head cancer is still disputed. The aim of this study was to analyze the data obtained from a large, single center with PPPD compared with PRPD in terms of postoperative outcomes, including blood glucose levels and survival in patients with pancreatic head cancer. Methods: Between January 2007 and December 2016, a total of 556 patients with pancreatic head cancer underwent either PPPD or PRPD. We analyzed the clinicopathologic data to assess short- and long-term outcomes retrospectively. Results: For underlying disease, patients with DM in PPPD were fewer than in PRPD (33.0% vs. 46.2%, p=0.002). The median value of CA19-9 was significantly higher in PRPD than in PPPD (129.36 vs. 86.47, p=0.037). The incidence of Clavien-Dindo grade III to V major complications in PPPD was significantly higher than in PRPD (20.4% vs. 13.4%, p=0.032). Resection of pylorus was shown to reduce complications in univariate and multivariate analyses (p=0.032 and = 0.021, respectively). The 5-year survival rates were 27.6% in the PPPD group and 22.4% in the PRPD group (p=0.015). Conclusions: The results of PPPD and PRPD showed no significant differences from those reported conventionally in previous studies. Although further well-designed studies are needed, it is more important to select the range of surgical resection for the patient’s disease regardless of resection of pylorus.

#Pancreaticoduodenectomy #Pylorus-preserving pancreaticoduodenectomy #Pylorus-resecting pancreaticoduodenectomy #Pancreatic cancer

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