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Preservation of the pylorus in resection of the head of the pancreas
Author(s) -
Moossa A. R.,
Veeragandham Ramesh S.
Publication year - 1994
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02391095
Subject(s) - medicine , pancreaticoduodenectomy , gastric emptying , pylorus , pancreas , anastomosis , incidence (geometry) , whipple procedure , general surgery , surgery , pancreatic fistula , gastroenterology , stomach , physics , optics
Abstract Pylorus preservation has been advocated to decrease the morbidity associated with the classical or standard pancreaticoduodenectomy. The proposed advantages are decreased incidence of peptic ulceration, dumping syndrome, and nutritional problems. However, after an initial period of enthusiasm for the procedure, it is now being found that marginal ulceration at the duodenojejunal anastomosis is encountered with increasing frequency. Delay in gastric emptying occurs frequently, with an overall incidence of 30%. With the availability of better pancreatic enzyme supplements, the current incidence of nutritional problems and weight loss after the standard Whipple procedure is unknown. Whether there is a difference in long‐term survival after the two procedures performed for adenocarcinoma of the head of the pancreas is still debatable. A controlled trial is needed to answer many of these questions, and pylorus‐preserving pancreaticoduodenectomy should be used cautiously until further data become available.