Document Detail


Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR?
MedLine Citation:
PMID:  11281176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
K Yamaguchi; K Yokohata; K Nakano; K Ohtani; Y Ogawa; K Chijiiwa; M Tanaka
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  46     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-04-02     Completed Date:  2001-04-12     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
4-Aminobenzoic Acid / 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:
0/Blood Glucose; 150-13-0/4-Aminobenzoic Acid; 37106-97-1/bentiromide; 9007-41-4/C-Reactive Protein

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


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