A prospective randomized comparison between pylorus- and subtotal stomach-preserving pancreatoduodenectomy on postoperative delayed gastric emptying occurrence and long-term nutritional status
Corresponding Author
Ippei Matsumoto MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Correspondence to: Ippei Matsumoto MD, PhD, Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 6500017, Japan. Fax: 81-78-382-6307. E-mail: [email protected]Search for more papers by this authorMakoto Shinzeki MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorSadaki Asari MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorTadahiro Goto MD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorSachiyo Shirakawa MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorTetsuo Ajiki MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorTakumi Fukumoto MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorYasuyuki Suzuki MD, PhD
Faculty of Medicine, Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorYonson Ku MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorCorresponding Author
Ippei Matsumoto MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Correspondence to: Ippei Matsumoto MD, PhD, Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 6500017, Japan. Fax: 81-78-382-6307. E-mail: [email protected]Search for more papers by this authorMakoto Shinzeki MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorSadaki Asari MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorTadahiro Goto MD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorSachiyo Shirakawa MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorTetsuo Ajiki MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorTakumi Fukumoto MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorYasuyuki Suzuki MD, PhD
Faculty of Medicine, Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan
Search for more papers by this authorYonson Ku MD, PhD
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
Search for more papers by this authorAbstract
Background and Objectives
Pylorus-preserving pancreatoduodenectomy (PPPD) has been associated with a high incidence of delayed gastric emptying (DGE). There are few studies comparing DGE associated with PPPD and subtotal stomach-preserving pancreatoduodenectomy (SSPPD). Moreover, differences between the procedures with respect to long-term results have not been reported. A prospective randomized study was conducted to compare perioperative complications and long-term nutritional status with PPPD and SSPPD.
Methods
One hundred patients with periampullary lesions were randomized to receive either PPPD (n = 50) or SSPPD (n = 50). All patients were followed up for 3 years after surgery or to the time of recurrence to evaluate nutritional status for the study. The effects of the procedure, age, and malignancy on changes in nutritional indicators were estimated with linear mixed models. This study was registered at UMIN Clinical Trials Registry (UMIN 000012337).
Results
The incidence of DGE assessed by the International Study Group of Pancreatic Surgery was 20% with PPPD and 12% with SSPPD (P = 0.414). There were no significant differences between the two procedures on postoperative serum albumin levels, serum total cholesterol levels, and body mass index during the 3-year follow-up period.
Conclusions
SSPPD is equally effective in DGE occurrence rate and long-term nutritional status comparing to PPPD. J. Surg. Oncol 2014; 109:690–696. © 2014 Wiley Periodicals, Inc.
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