Comparison between a Pylorus-Preserving Pancreatoduodenectomy and a Classical Pancreatoduodenectomy Nutritional status and quality of life.
- Author:
Chai Young LEE
1
;
Young Joo LEE
;
Shin WHANG
;
Kwang Min PARK
;
Dong Rak CHOI
;
Ki Hun KIM
;
Sung Gyu LEE
Author Information
1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Pylorus-preserving pancreatoduodenectomy;
Classical pancreatoduodenectomy;
Nutritional status;
Quality of life
- MeSH:
Cholesterol;
Drainage;
Humans;
Length of Stay;
Mortality;
Nutritional Status*;
Operative Time;
Pancreatic Neoplasms;
Pancreaticoduodenectomy*;
Pylorus;
Quality of Life*;
Recurrence;
Retrospective Studies;
Survival Rate
- From:Journal of the Korean Surgical Society
2000;58(1):85-93
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: This study was performed to prove whether a pylorus-preserving pancreatoduodenectomy (PPPD), now widely used in the treatment of not only positive tumors but also negative tumors, is advantageous for recovering the nutritional status and the quality of life of patients with pancreatic cancer and periampullary regions compared with a classical pancreatoduodenectomy (PD). METHODS: A retrospective study of the nutritional status and the quality of life of 200 patients who had undergone a PPPD (n=92) and a PD (n=118) from January 1993 to July 1998 was performed. The nutritional status was measured by using Broca's index, cholesterol, total protein, and albumin. The quality of life was assessed by one question on how the patients felt about their quality of life. RESULTS: The PD was preferred in advanced stages and had a higher recurrence rate. The PPPD had a shorter operative time, less transfused blood, a longer duration of nasogastric tube drainage, and a shorter postoperative hospital stay. In the PPPD, the nutritional status was improved compared with that in the PD. There were no significant differences in operative mortality or morbidity, gastrointestinal symptoms, and the quality of life between patients having a PPPD and a PD. CONCLUSIONS: This study suggests that there are no differences in postoperative subjective symptoms and the quality of life between patients having a PPPD and those having a PD. However, preserving the pylorus allows a better recovery of nutritional status than a pylorus resection dose. The PPPD hasa survival rate similar to that of the PD. Therefore, the PPPD can be recommended for the procedure in the surgical treatment of diseases of the periampullary regions.
