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Comparison of long-term benefits of organ-preserving pancreatectomy techniques for benign or low-grade malignant tumors at the pancreatic head.

Abstract The aim of this article was to investigate and emphasize the clinical benefits of organ-preserving surgeries by comparing the pancreatic head resection with segmental duodenectomy (PHRSD), pylorus-preserving pancreatoduodenectomy (PPPD), and classic pancreatoduodenectomy (PD).A retrospective analysis of PHRSD (20 patients), PPPD (42 patients), and PD (92 patients) with benign lesions, low-grade malignancies, or early-stage carcinomas at the pancreatic head was performed since 2008. The intraoperative and postoperative courses and a long-term statuses were compared.The overall average age of the patients in 3 groups was 48.82 years old (range 12-76). The mean operative time and the blood loss were significantly less in the PHRSD and PPPD groups than that in the PD group (P < .05), but there were no differences between the PHRSD and PPPD groups. The possibilities of postoperative complications were equivalent in all 3 groups. During an average follow-up time of 61.1 months, there were no recurrence or distant metastasis happened. Patients in the PHRSD and PPPD groups had a better long-term nutritional status because they had less body weight loss (P < .01), and suffered less from long-term diarrhea (P < .001) than that in the PD group. However, the results in the PPPD group seemed to be better than that in the PHRSD group.PHRSD and PPPD are ideal procedures of organ-preserving pancreatectomy to fulfill the curative goals of benign lesions, low-grade malignancies, or early-stage carcinomas at the pancreatic head. It was proved to be operative safe and could bring patients with a better nutritional status and quality of life after surgery. However, PHRSD was more difficult with no better long-term benefits than PPPD, which asked a comprehensive consideration when made the surgical choice.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390567
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Comparison of long-term benefits of organ-preserving pancreatectomy techniques
      for benign or low-grade malignant tumors at the pancreatic head.
PG  - e9420
LID - 10.1097/MD.0000000000009420 [doi]
AB  - The aim of this article was to investigate and emphasize the clinical benefits of
      organ-preserving surgeries by comparing the pancreatic head resection with
      segmental duodenectomy (PHRSD), pylorus-preserving pancreatoduodenectomy (PPPD), 
      and classic pancreatoduodenectomy (PD).A retrospective analysis of PHRSD (20
      patients), PPPD (42 patients), and PD (92 patients) with benign lesions,
      low-grade malignancies, or early-stage carcinomas at the pancreatic head was
      performed since 2008. The intraoperative and postoperative courses and a
      long-term statuses were compared.The overall average age of the patients in 3
      groups was 48.82 years old (range 12-76). The mean operative time and the blood
      loss were significantly less in the PHRSD and PPPD groups than that in the PD
      group (P &lt; .05), but there were no differences between the PHRSD and PPPD groups.
      The possibilities of postoperative complications were equivalent in all 3 groups.
      During an average follow-up time of 61.1 months, there were no recurrence or
      distant metastasis happened. Patients in the PHRSD and PPPD groups had a better
      long-term nutritional status because they had less body weight loss (P &lt; .01),
      and suffered less from long-term diarrhea (P &lt; .001) than that in the PD group.
      However, the results in the PPPD group seemed to be better than that in the PHRSD
      group.PHRSD and PPPD are ideal procedures of organ-preserving pancreatectomy to
      fulfill the curative goals of benign lesions, low-grade malignancies, or
      early-stage carcinomas at the pancreatic head. It was proved to be operative safe
      and could bring patients with a better nutritional status and quality of life
      after surgery. However, PHRSD was more difficult with no better long-term
      benefits than PPPD, which asked a comprehensive consideration when made the
      surgical choice.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Li, Yatong
AU  - Li Y
AD  - Department of General Surgery, Peking Union Medical College Hospital, Beijing,
      China.
FAU - Wu, Wenming
AU  - Wu W
FAU - Zhang, Taiping
AU  - Zhang T
FAU - Liao, Quan
AU  - Liao Q
FAU - Zhao, Yupei
AU  - Zhao Y
FAU - Dai, Menghua
AU  - Dai M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Blood Loss, Surgical
MH  - Child
MH  - Duodenum/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Pancreas/surgery
MH  - Pancreatectomy/adverse effects/*methods
MH  - Pancreatic Neoplasms/*surgery
MH  - Pancreaticoduodenectomy/adverse effects/methods
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5758269
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009420 [doi]
AID - 00005792-201712220-00154 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e9420. doi: 10.1097/MD.0000000000009420.