Improved outcomes for benign disease with limited pancreatic head resection

Gudrun Aspelund, Mark D. Topazian, Jeffrey H. Lee, Dana Andersen

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

We sought to determine whether duodenum-preserving pancreatic head resections (DPPHRs) offer improved outcomes for benign disease of the proximal pancreas. A single-cohort study was performed of 86 consecutive patients who underwent DPPHR, extended lateral pancreaticojejunostomy with excavation of the pancreatic head (ELPJ), standard or pylorus-sparing Whipple procedure (WHIP), or distal pancreatectomy (DPR). Aspects of cost, complications (mortality and morbidity), and outcomes were assessed during a follow-up period of 6-63 months (mean, 3 years). Twelve DPPHR and 12 ELPJ procedures were performed for benign lesions or chronic pancreatitis (CP), as were 7 of 30 WHIP procedures and 12 of 16 DPRs. Operative time was significantly less than that for WHIP in ELPJ and DPR procedures. Major complications occurred in 40% of WHIPs and 25% of DPPHRs but only 16% of ELPJs (P <0.05). Thirty-day mortality was 2 of 30 for WHIP but 0 for all other procedures. Pancreatic or biliary leak occurred in 3 of 30 WHIPs, 3 of 12 DPPHRs, 1 of 16 DPRs, and 0 of 12 ELPJs. New diabetes occurred in 25% of patients who underwent WHIP but only 8% of both DPPHR and ELPJ patients. Full functional recovery was similar for CP patients in both DPPHR and ELPJ. DPPHR and ELPJ are effective surgical approaches to the treatment of benign tumors and CP and are safer than WHIP with lower morbidity and mortality risks. The incidence of new diabetes is less with both ELPJ and DPPHR.

Original languageEnglish (US)
Pages (from-to)400-409
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume9
Issue number3
DOIs
StatePublished - Mar 1 2005
Externally publishedYes

Fingerprint

Duodenum
Chronic Pancreatitis
Pancreatectomy
Mortality
Head
Pancreaticojejunostomy
Morbidity
Pylorus
Operative Time
Pancreas
Cohort Studies
Costs and Cost Analysis
Incidence

Keywords

  • Beger procedure
  • Chronic pancreatitis
  • Duodenum-preserving pancreatic head resection
  • Frey procedure
  • Pancreatic surgery
  • Whipple procedure

ASJC Scopus subject areas

  • Surgery

Cite this

Improved outcomes for benign disease with limited pancreatic head resection. / Aspelund, Gudrun; Topazian, Mark D.; Lee, Jeffrey H.; Andersen, Dana.

In: Journal of Gastrointestinal Surgery, Vol. 9, No. 3, 01.03.2005, p. 400-409.

Research output: Contribution to journalArticle

Aspelund, Gudrun ; Topazian, Mark D. ; Lee, Jeffrey H. ; Andersen, Dana. / Improved outcomes for benign disease with limited pancreatic head resection. In: Journal of Gastrointestinal Surgery. 2005 ; Vol. 9, No. 3. pp. 400-409.
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