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Table of Contents
Vol. 19, No. 1, 2002
Issue release date: 2002
Section title: Original Paper
Dig Surg 2002;19:28–35
(DOI:10.1159/000052002)

Clinical Experience with Different Techniques of Pancreatic Head Resection for Chronic Pancreatitis / with Invited Commentary

Kelemen D. · Horváth Ö.P.
Department of Surgery, Medical Faculty, Pécs University, Pécs, Hungary

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 4/8/2002

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 7

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Background/Aims: Recently organ-saving procedures have become popular in the treatment of chronic pancreatitis with head enlargement. The purpose of this study is to compare the results of three different procedures. Methods: Between 1991 and 1998, 32 Beger operations, 13 Frey procedures and 21 pylorus-preserving pancreatoduodenectomies (PPPDs) were performed. The pre-, intra- and postoperative data were detailed. During the follow-up examination the quality of life, body weight, consumption of alcohol and enzymes, as well as the carbohydrate metabolism were checked. Results: Considering the operative and late mortality and reoperation rate, there was no difference between the procedures. The postoperative hospitalization time was the shortest after the duodenum-preserving pancreatic head resections (Beger and Frey). While the rate of early morbidity was higher after PPPDs, there was no difference in late morbidity between the groups. The condition of the patients was better and the development rate of diabetes was lower after the Beger procedure than after PPPDs. Conclusion: Consequently duodenum-preserving pancreatic head resections seem to be more advantageous than PPPD. Nevertheless the latter operation is the only possibility in some situations.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 4/8/2002

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 7

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Büchler M, Malfertheiner P, Friess H, Senn T, Beger HG: Chronic pancreatitis with inflammatory mass in the head of the pancreas: A special entity?; in Beger HG, Büchler M, Ditschuneit H, Malfertheiner P (eds): Chronic Pancreatitis. New York, Springer, 1990, pp 41–46.
  2. Beger HG, Büchler M, Bittner R, Oettinger W, Roscher R: Duodenum-preserving resection of the head of the pancreas in severe chronic pancreatitis. Ann Surg 1989;209:273–278.

    External Resources

  3. Beger HG, Witte C, Kraas E, Bittner R: Erfahrung mit einer das Duodenum erhaltenden Pankreaskopfresektion bei chronischer Pankreatitis. Chirurg 1980;51:303–309.

    External Resources

  4. Bockman D, Büchler M, Malfertheiner P, Beger HG: Analysis of nerves in chronic pancreatitis. Gastroenterology 1988;94:1459–1469.
  5. Whipple AO, Pearson WB, Mullins CR: Treatment of carcinoma of the ampulla of Vater. Ann Surg 1935:102:763–769.
  6. Watson K: Carcinoma of the ampulla of Vater: Successful radical resection. Br J Surg 1944;31:368–377.
  7. Traverso LW, Longmire WP: Preserving of the pylorus in pancreatico-duodenoectomy. Surg Gynecol Obstet 1978;146:959–962.
  8. Flautner L, Tihanyi T, Szécsény A: Pancreatogastrostomy: An ideal complement to pancreatic head resection with preservation of the pylorus in the treatment of chronic pancreatitis. Am J Surg 1985;150:608–611.

    External Resources

  9. Bittner R, Butters M, Büchler M: Glucose homeostasis and endocrine pancreatic function in patients with chronic pancreatitis before and after surgical therapy. Pancreas 1994;9:47–53.
  10. Creutzfeldt W, Ebert R: The enteroinsular axis; in Go VLW, Lebenthal E, DiMagno EP (eds): The Pancreas. Biology, Pathobiology, and Disease. New York, Raven Press, 1993, pp 769–788.
  11. Gooszen HG, Guicherit OR, van der Burg MPM, Jansen JBMJ, Frölich M, Lamers CBHW: Endocrine function after duodenum-preserving resection of the head of the pancreas with or without segmental pancreatic autotransplantation: an experimental study in dogs; in Beger HG, Büchler M, Ditschuneit H, Malfertheiner P (eds): Chronic Pancreatitis. New York, Springer, 1990, pp 517–525.
  12. Malfertheiner P, Sarr MG, Nelson DK, DiMagno EP: Role of the duodenum in postprandial release of pancreatic and gastrointestinal hormones. Pancreas 1994;9:13–19.
  13. Frey CF, Smith GJ: Description and rationale of a new operation for chronic pancreatitis. Pancreas 1987;2:701–707.
  14. Hanyu F, Suzuki M, Imaizumi T: Resection of the head of the pancreas in the treatment of chronic pancreatitis; in Beger HG, Büchler M, Ditschuneit H, Malfertheiner P (eds): Chronic Pancreatitis. New York, Springer, 1990, pp 490–495.
  15. Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM, Schmülling C, Neugebauer E, Troidl H: Gastrointestinal Quality of Life Index: Development, validation and application of a new instrument. Br J Surg 1995;82:216–222.
  16. Beger HG, Büchler M, Bittner R, Uhl W: Duodenum-preserving resection of the head of the pancreas – An alternative to Whipple’s procedure in chronic pancreatitis. Hepatogastroenterology 1990;37:283–289.
  17. Beger HG, Schoenberg MH, Link KH, Safi F, Berger D: Die duodenumerhaltende Pankreaskopfresektion – ein Standardverfahren bei chronischer Pankreatitis. Chirug 1997;68:874–880.
  18. Büchler MW, Friess H, Müller MW, Beger HG: Die duodenumerhaltende Pankreaskopfresektion: Eine neue Standardoperation bei chronischer Pankreatitis. Langenbecks Arch Chir Suppl Kongressbd 1997;114:1081–1083.
  19. Friess H, Müller MW, Büchler MW: Which is the better operation in chronic pancreatitis: Pylorus-preserving Whipple or duodenum-preserving pancreatic head resection? Dig Surg 1996;13:141–149.
  20. Ho HS, Frey CF: Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy: Rationale and results in patients with chronic pancreatitis. Dig Surg 1996;13:134–140.
  21. Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE: Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. Ann Surg 1995;221:350–358.
  22. Kelemen D, Cseke L, Fenyvesi I, Horváth ÖP, Deák G: First experiences with duodenum-preserving resection of the head of the pancreas in the treatment of chronic pancreatitis. Dig Surg 1996;13:209–212.
  23. Traverso LW, Kozarek RA: Long-term follow-up after pylorus-preserving pancreatoduodenectomy for severe complications of chronic pancreatitis. Dig Surg 1996;13:118–126.
  24. Wilker DK, Schweiberer L, Knoefel WT, Izbicki JR, Geissler K, Eibl-Eibesfeldt B: Duodenum-preserving resection of the head of the pancreas in the treatment of chronic pancreatitis: The Munich experience; in Beger HG, Büchler M, Ditschuneit H, Malfertheiner P (eds): Chronic Pancreatitis. New York, Springer, 1990, pp 532–538.
  25. Büchler MW, Beger HG, Tang Wen-Hao, Friess H: Management of chronic pancreatitis with an inflammatory mass. Probl Gen Surg 1998;15:100–110.
  26. Büchler MW, Friess H, Müller MW, Wheatley AM, Beger HG: Randomised trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis. Am J Surg 1995;169:65–70.
  27. Müller MW, Friess H, Beger HG, Kleeff J, Lauterburg B, Glasbrenner B, Riepl RL, Büchler MW: Gastric emptying following pylorus-preserving Whipple and duodenum-preserving pancreatic head resection in patients with chronic pancreatitis. Am J Surg 1997;173:257–263.
  28. Izbicki JR, Broering DC, Knoefel WT, Kuechler T, Broelsch CE: Extended drainage versus resection in surgery for chronic pancreatitis. Ann Surg 1998;228:771–779.
  29. Bloechle C, Busch C, Tesch C, Nicolas V, Binmoeller KF, Soehendra N, Izbicki JR: Prospective randomised study of drainage and resection on non-occlusive segmental portal hypertension in chronic pancreatitis. Br J Surg 1997;84:477–482.
  30. Frey CH, Suzuki M, Isaji S, Zhu Y: Pancreatic resection for chronic pancreatitis. The pancreas. Surg Clin North Am 1989;69:499–528.

    External Resources

  31. Holmberg JT, Isaksson G, Ihse I: Long term results of pancreaticojejunostomy in chronic pancreatitis. Surg Gynecol Obstet 1985;160:339–346.

    External Resources

  32. Little JM: Alcohol abuse and chronic pancreatitis. Surgery 1987;101:357–360.

    External Resources

  33. Pap Á: Pancreatic adaptation, growth and regeneration in experimental chronic pancreatitis; in Beger HG, Büchler M, Ditschuneit H, Malfertheiner P (eds): Chronic Pancreatitis. New York, Springer, 1990, pp 122–133.
  34. Gloor B, Friess H, Uhl W, Büchler MW: A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg 2001;18:21–25.