BACKGROUND: For chronic pancreatitis, European prospective trials have concluded that duodenum-preserving head resections (DPHR) are associated with less morbidity and similar pain relief and quality of life (QoL) outcomes compared with pancreaticoduodenectomy (PD). However, DPHR procedures are seldom performed in North America. METHODS: Patients undergoing PD or DPHR for unremitting pain secondary to chronic pancreatitis were retrospectively identified. Quality of life was assessed cross-sectionally using the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire (QLQ-C30) and pancreatic cancer-specific supplemental module (QLQ-PAN26). RESULTS: Eighty-one patients underwent either a Whipple PD (n= 59) or a DPHR (Bern, Beger or Frey procedure, n= 22) for the treatment of pain caused by chronic pancreatitis over a 5-year period. The characteristics of patients undergoing DPHR and PD procedures were similar. Duration of procedure (360 min vs. 245 min), duration of hospital stay (12.0 days vs. 9.5 days) and estimated blood loss (535 ml vs. 214 ml) were all significantly less for DPHR patients (P < 0.05). Thirty-day morbidity and mortality, postoperative pain relief and QoL scores did not differ significantly between groups. CONCLUSIONS: Duodenum-preserving head resection is equally as effective as PD in relieving pain and improving QoL in chronic pancreatitis patients, and involves a shorter hospital stay and less blood loss.
BACKGROUND: For chronic pancreatitis, European prospective trials have concluded that duodenum-preserving head resections (DPHR) are associated with less morbidity and similar pain relief and quality of life (QoL) outcomes compared with pancreaticoduodenectomy (PD). However, DPHR procedures are seldom performed in North America. METHODS:Patients undergoing PD or DPHR for unremitting pain secondary to chronic pancreatitis were retrospectively identified. Quality of life was assessed cross-sectionally using the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire (QLQ-C30) and pancreatic cancer-specific supplemental module (QLQ-PAN26). RESULTS: Eighty-one patients underwent either a Whipple PD (n= 59) or a DPHR (Bern, Beger or Frey procedure, n= 22) for the treatment of pain caused by chronic pancreatitis over a 5-year period. The characteristics of patients undergoing DPHR and PD procedures were similar. Duration of procedure (360 min vs. 245 min), duration of hospital stay (12.0 days vs. 9.5 days) and estimated blood loss (535 ml vs. 214 ml) were all significantly less for DPHR patients (P < 0.05). Thirty-day morbidity and mortality, postoperative pain relief and QoL scores did not differ significantly between groups. CONCLUSIONS: Duodenum-preserving head resection is equally as effective as PD in relieving pain and improving QoL in chronic pancreatitispatients, and involves a shorter hospital stay and less blood loss.
Authors: D Fitzsimmons; C D Johnson; S George; S Payne; A A Sandberg; C Bassi; H G Beger; D Birk; M W Büchler; C Dervenis; L Fernandez Cruz; H Friess; A L Grahm; J Jeekel; R Laugier; D Meyer; M W Singer; T Tihanyi Journal: Eur J Cancer Date: 1999-06 Impact factor: 9.162
Authors: Deborah Fitzsimmons; Stefan Kahl; Giovanni Butturini; Marc van Wyk; Phillipus Bornman; Claudio Bassi; Peter Malfertheiner; Steve L George; Colin D Johnson Journal: Am J Gastroenterol Date: 2005-04 Impact factor: 10.864
Authors: C Möbius; D Max; D Uhlmann; K Gumpp; J Behrbohm; K Horvath; J Hauss; H Witzigmann Journal: Langenbecks Arch Surg Date: 2007-03-21 Impact factor: 2.895
Authors: Daniel J Kilburn; Adrian K H Chiow; Universe Leung; Mehan Siriwardhane; David J Cavallucci; Richard Bryant; Nicholas A O'Rourke Journal: J Gastrointest Surg Date: 2016-12-26 Impact factor: 3.452