| Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR? | |
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MedLine Citation:
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PMID: 11281176 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Less invasive pancreatic head resection, such as pylorus preserving pancreatoduodenectomy (PPPD) and duodenum preserving pancreatic head resection (DPPHR) has been introduced for the treatment of pancreatoduodenal lesions, especially for benign conditions, in consideration of postoperative quality of life. Surgical stress and exocrine and endocrine function of the residual pancreas were examined in 44 patients with PPPD, 10 with conventional pancreatoduodenectomy (PD) and six with DPPHR. Clinical findings including serum levels of C reactive protein (CRP), fasting blood sugar, a 120-min value of the 75-g oral glucose tolerance test (OGTT), N-benzol-L-tyrosyl-p-aminobenzoic acid (BT-PABA) excretion value (a pancreatic exocrine function test), and volume of postoperative pancreatic juice drainage were compared among the three different variants of pancreatectomy. Operation time and operative blood loss in PD were largest of the three, followed by PPPD and DPPHR. Postoperative elevation of serum CRP on postoperative day (POD) 2 or 3 was similar among the three different types of operation. Fasting blood sugar concentrations were not different among the three groups at short- and long-term after the operation, while the 120-min value of the GTT showed a marked elevation at long-term only after PPPD. The volume of pancreatic juice drainage increased up to POD 4 and became constant thereafter. The total amount of pancreatic juice drainage from POD 4 to 13 was smallest in PD (637 ml) followed by PPPD (1,255 ml) and DPPHR (1,431 ml). The BT-PABA value declined after PD (-20.3%, P = 0.0437) and PPPD (-20.2%, P = 0.0239) at short term, but not after DPPHR (8.2%). These findings suggest that the early impairment of the pancreatic exocrine function after PD and PPPD but not after DPPHR may indicate that the invasiveness of pancreatic head resection to the pancreatic functions is greater in PD and PPPD than in DPPHR. |
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Authors:
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K Yamaguchi; K Yokohata; K Nakano; K Ohtani; Y Ogawa; K Chijiiwa; M Tanaka |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Digestive diseases and sciences Volume: 46 ISSN: 0163-2116 ISO Abbreviation: Dig. Dis. Sci. Publication Date: 2001 Feb |
Date Detail:
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Created Date: 2001-04-02 Completed Date: 2001-04-12 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7902782 Medline TA: Dig Dis Sci Country: United States |
Other Details:
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Languages: eng Pagination: 282-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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4-Aminobenzoic Acid
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analogs & derivatives*,
diagnostic use,
pharmacokinetics Aged Blood Glucose / analysis Blood Loss, Surgical / statistics & numerical data C-Reactive Protein / metabolism Female Follow-Up Studies Humans Male Metabolic Clearance Rate Middle Aged Pancreatectomy / adverse effects*, methods* Pancreatic Function Tests Pancreatic Juice / secretion Pancreatic Neoplasms / blood, pathology, surgery* Pancreaticoduodenectomy / adverse effects*, methods* Stress, Physiological / blood, etiology Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 150-13-0/4-Aminobenzoic Acid; 37106-97-1/bentiromide; 9007-41-4/C-Reactive Protein |
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