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Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis.
Langenbecks Arch Surg. 2007 May; 392(3):359-64.LA

Abstract

BACKGROUND

Three prospective randomised studies were conducted to compare pancreatoduodenectomy (PD) with duodenum-preserving pancreatic head resection (DPPHR) in patients suffering from chronic pancreatitis (cP). In these three series, the superiority of the duodenum-preserving technique with regard to quality of life (QOL) and pain relief has been demonstrated. Long-term follow-up investigations have not been published so far. The present paper reports on a 5-year follow-up study of a prospective, non-randomised trial comparing classic Whipple procedure (PD) with Beger DPPHR.

MATERIALS AND METHODS

Seventy patients were initially enrolled in this study. Fifty-one patients were left for the present long-term outcome analysis (PD, n = 24; DPPHR, n = 27). The follow-up included the following parameters: QOL, pain intensity, endocrine and exocrine function, and body mass index (BMI).

RESULTS

The median follow-up was 63.5 (range 56-67) months. Two patients in the DPPHR group and none in the PD group underwent a re-operation. The QOL scores of the relevant symptom scales (nausea, pain, diarrhoea) and functional parameters (physical status, working ability, global QOL) were significantly better in the DPPHR group than in the PD group. Pain intensity as self-assessed by the patients was less pronounced in the DPPHR group (P < 0.001), whereas the frequency of acute episodes and analgesic medication did not differ between the two groups. No difference was observed between the two groups with regard to endocrine and exocrine function. The values of the median body mass index (BMI) in the PD group [23.4 (range 18.5-25.0) kg/m(2)] and in the DPPHR group [24.2 (range 17.9-27.8) kg/m(2)] were comparable. The 5-year outcome remained stable compared to the early post-operative data published elsewhere.

CONCLUSION

This 5-year long-term outcome analysis documents the superiority of the Beger duodenum-preserving technique over the classic Whipple procedure in terms of QOL and pain intensity as self-assessed by the patients.

Authors+Show Affiliations

Department of Surgery II, University of Leipzig, Leipzig, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17375317

Citation

Möbius, C, et al. "Five-year Follow-up of a Prospective Non-randomised Study Comparing Duodenum-preserving Pancreatic Head Resection With Classic Whipple Procedure in the Treatment of Chronic Pancreatitis." Langenbeck's Archives of Surgery, vol. 392, no. 3, 2007, pp. 359-64.
Möbius C, Max D, Uhlmann D, et al. Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis. Langenbecks Arch Surg. 2007;392(3):359-64.
Möbius, C., Max, D., Uhlmann, D., Gumpp, K., Behrbohm, J., Horvath, K., Hauss, J., & Witzigmann, H. (2007). Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis. Langenbeck's Archives of Surgery, 392(3), 359-64.
Möbius C, et al. Five-year Follow-up of a Prospective Non-randomised Study Comparing Duodenum-preserving Pancreatic Head Resection With Classic Whipple Procedure in the Treatment of Chronic Pancreatitis. Langenbecks Arch Surg. 2007;392(3):359-64. PubMed PMID: 17375317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis. AU - Möbius,C, AU - Max,D, AU - Uhlmann,D, AU - Gumpp,K, AU - Behrbohm,J, AU - Horvath,K, AU - Hauss,J, AU - Witzigmann,H, Y1 - 2007/03/21/ PY - 2006/11/25/received PY - 2007/02/13/accepted PY - 2007/3/22/pubmed PY - 2007/12/7/medline PY - 2007/3/22/entrez SP - 359 EP - 64 JF - Langenbeck's archives of surgery JO - Langenbecks Arch Surg VL - 392 IS - 3 N2 - BACKGROUND: Three prospective randomised studies were conducted to compare pancreatoduodenectomy (PD) with duodenum-preserving pancreatic head resection (DPPHR) in patients suffering from chronic pancreatitis (cP). In these three series, the superiority of the duodenum-preserving technique with regard to quality of life (QOL) and pain relief has been demonstrated. Long-term follow-up investigations have not been published so far. The present paper reports on a 5-year follow-up study of a prospective, non-randomised trial comparing classic Whipple procedure (PD) with Beger DPPHR. MATERIALS AND METHODS: Seventy patients were initially enrolled in this study. Fifty-one patients were left for the present long-term outcome analysis (PD, n = 24; DPPHR, n = 27). The follow-up included the following parameters: QOL, pain intensity, endocrine and exocrine function, and body mass index (BMI). RESULTS: The median follow-up was 63.5 (range 56-67) months. Two patients in the DPPHR group and none in the PD group underwent a re-operation. The QOL scores of the relevant symptom scales (nausea, pain, diarrhoea) and functional parameters (physical status, working ability, global QOL) were significantly better in the DPPHR group than in the PD group. Pain intensity as self-assessed by the patients was less pronounced in the DPPHR group (P < 0.001), whereas the frequency of acute episodes and analgesic medication did not differ between the two groups. No difference was observed between the two groups with regard to endocrine and exocrine function. The values of the median body mass index (BMI) in the PD group [23.4 (range 18.5-25.0) kg/m(2)] and in the DPPHR group [24.2 (range 17.9-27.8) kg/m(2)] were comparable. The 5-year outcome remained stable compared to the early post-operative data published elsewhere. CONCLUSION: This 5-year long-term outcome analysis documents the superiority of the Beger duodenum-preserving technique over the classic Whipple procedure in terms of QOL and pain intensity as self-assessed by the patients. SN - 1435-2443 UR - https://www.unboundmedicine.com/medline/citation/17375317/Five_year_follow_up_of_a_prospective_non_randomised_study_comparing_duodenum_preserving_pancreatic_head_resection_with_classic_Whipple_procedure_in_the_treatment_of_chronic_pancreatitis_ L2 - https://dx.doi.org/10.1007/s00423-007-0175-4 DB - PRIME DP - Unbound Medicine ER -