Duodenopancreatectomy versus Duodenum-Preserving Pancreatic Head Excision for Chronic PancreatitisBelina F. · Fronek J. · Ryska M.
Department of Surgery, Central Military Hospital, Prague, Czech Republic
Background: The aim of this study was to compare two surgical procedures in the treatment for chronic pancreatitis (CP): pancreatoduodenectomy resection (classical Whipple – PD procedure, or pylorus-preserving – PPPD) to duodenum-preserving pancreatic head excision with longitudinal pancreatojejunoanastomosis (DPPHE/PJA), to define the advantages of each procedure with regard to postoperative complications, pain relief, and the quality of life. Material and Method: 104 consecutive patients were included into this study. Duodenopancreatectomy was chosen when the head pancreatic mass was present or pancreatic cancer could not be ruled out (48 patients); otherwise DPPHE/PJA was performed (56 patients). Quality of life was measured prospectively on two occasions, before the procedure and during follow-up (median 39 months after surgery) using the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire (QLQ-C30). The test was re-evaluated for patients suffering from CP. Pain intensity was quantified using a specially designed pain score. Early postoperative morbidity and mortality were assessed and evaluated in both groups of patients. Results: Total pain score decreased significantly after surgery in both groups of patients. During the follow-up period, the global quality of life improved by 30.4% in the DPPHE/PJA group, and by 23.2% in the PD/PPPD group. Postoperative morbidity and mortality were higher in the resection group, but the differences were not significant. Conclusions: Both surgical procedures led to significant improvement in the quality of life and pain relief after surgery for CP. The EORTC QLQ-C30 was found to be a valid and readily available test for quality-of-life assessment in patients with CP.
Miroslav Ryska, MD, PhD
Surgery Department, Central Military Hospital
160 00 Prague 6 (Czech Republic)
Tel. +420 973 202905, Fax +420 973 202898
Received: December 3, 2003
Accepted after revision: February 28, 2004
Published online: August 16, 2005
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 6, Number of References : 18
Vol. 5, No. 6, Year 2005 (Cover Date: 2005)
Journal Editor: Urrutia, R. (Rochester, Minn.)
ISSN: 1424–3903 (print), 1424–3911 (Online)
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