Document Detail

Duodenum-preserving pancreatic head resection--a randomized controlled trial comparing the original Beger procedure with the Berne modification (ISRCTN No. 50638764).
MedLine Citation:
PMID:  18374046     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: A prospective, randomized study was performed to evaluate two variations of the duodenum-preserving pancreatic head resection (DPPHR), either with (Beger procedure) or without (Berne modification) the division of the pancreas anterior to the portal vein, in patients with chronic pancreatitis. METHODS: Randomized, controlled, patient-blinded trial of patients with inflammatory pancreatic head tumors. The primary endpoint was the duration of surgery. Other a priori-ordered endpoints were length of ICU stay, postoperative complication, length of hospital stay, and quality of life after 24 months. RESULTS: Sixty-five patients were randomized to the Berne or Beger procedures. The Berne modification could be performed faster (46 minutes difference, P < .05). The median length of stay on the ICU was one day in both groups (P = .97) but the median hospital stay was shorter in the Berne group (11 (8-39) versus 15 (8-47); P = .015). The quality of life two years after surgery did not differ significantly between the two groups (EORTC-QLQ-C30, Beger 65.6% vs. Berne 71.3%, P = .371). Three patients who had received the Berne procedure were reoperated on during the follow-up period due to ongoing pancreatitis and bile duct obstruction (P = .22). CONCLUSION: The Berne technique is technically simpler compared with the original Beger procedure, reflected in its significantly shorter operation times and hospital stays. The quality of life is similar after both procedures. The Berne modification of DPPHR adds to our panel of surgical procedures that can be applied with effective early and late outcomes.
Jörg Köninger; Christoph M Seiler; Stefan Sauerland; Moritz N Wente; Margot A Reidel; Michael W Müller; Helmut Friess; Markus W Büchler
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-03-04
Journal Detail:
Title:  Surgery     Volume:  143     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-04-28     Revised Date:  2008-09-16    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  490-8     Citation Subset:  AIM; IM    
Department of General Surgery, University of Heidelberg, Heidelberg, Germany.
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MeSH Terms
Duodenum / surgery*
Length of Stay
Middle Aged
Pancreas / surgery
Pancreatectomy / methods*
Pancreatitis, Chronic / surgery*
Portal Vein / surgery
Prospective Studies
Quality of Life
Single-Blind Method
Time Factors
Comment In:
Surgery. 2008 Sep;144(3):478; author reply 478-9   [PMID:  18707050 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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