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Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review.
Am Surg. 2015 Sep; 81(9):909-14.AS

Abstract

Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief (P = 0.24), endocrine insufficiency (P = 0.15), and perioperative morbidity (P = 0.13) between DPPHR and PPPD. However, quality of life (P < 0.00001), professional rehabilitation (P = 0.004), exocrine insufficiency (P = 0.005), and LOS (P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis.

Authors+Show Affiliations

Department of General Surgery, Florida Hospital Tampa, Tampa, Florida, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

26350671

Citation

Sukharamwala, Prashant B., et al. "Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection Over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: a Meta-analysis and Systematic Review." The American Surgeon, vol. 81, no. 9, 2015, pp. 909-14.
Sukharamwala PB, Patel KD, Teta AF, et al. Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review. Am Surg. 2015;81(9):909-14.
Sukharamwala, P. B., Patel, K. D., Teta, A. F., Parikh, S., Ross, S. B., Ryan, C. E., & Rosemurgy, A. S. (2015). Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review. The American Surgeon, 81(9), 909-14.
Sukharamwala PB, et al. Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection Over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: a Meta-analysis and Systematic Review. Am Surg. 2015;81(9):909-14. PubMed PMID: 26350671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term Outcomes Favor Duodenum-preserving Pancreatic Head Resection over Pylorus-preserving Pancreaticoduodenectomy for Chronic Pancreatitis: A Meta-analysis and Systematic Review. AU - Sukharamwala,Prashant B, AU - Patel,Krishen D, AU - Teta,Anthony F, AU - Parikh,Shailraj, AU - Ross,Sharona B, AU - Ryan,Carrie E, AU - Rosemurgy,Alexander S, PY - 2015/9/10/entrez PY - 2015/9/10/pubmed PY - 2015/12/15/medline SP - 909 EP - 14 JF - The American surgeon JO - Am Surg VL - 81 IS - 9 N2 - Pylorus-preserving pancreaticoduodenectomy (PPPD) and duodenum-preserving pancreatic head resection (DPPHR) are important treatment options for patients with chronic pancreatitis. This meta-analysis was undertaken to compare the long-term outcomes of DPPHR versus PPPD in patients with chronic pancreatitis. A systematic literature search was conducted using Embase, MEDLINE, Cochrane, and PubMed databases on all studies published between January 1991 and January 2013 reporting intermediate and long-term outcomes after DPPHR and PPPD for chronic pancreatitis. Long-term outcomes of interest were complete pain relief, quality of life, professional rehabilitation, exocrine insufficiency, and endocrine insufficiency. Other outcomes of interest included perioperative morbidity and length of stay (LOS). Ten studies were included comprising of 569 patients. There was no significant difference in complete pain relief (P = 0.24), endocrine insufficiency (P = 0.15), and perioperative morbidity (P = 0.13) between DPPHR and PPPD. However, quality of life (P < 0.00001), professional rehabilitation (P = 0.004), exocrine insufficiency (P = 0.005), and LOS (P = 0.00001) were significantly better for patients undergoing DPPHR compared with PPPD. In conclusion, there is no significant difference in endocrine insufficiency, postoperative pain relief, and perioperative morbidity for patients undergoing DPPHR versus PPPD. Improved intermediate and long-term outcomes including LOS, quality of life, professional rehabilitation, and preservation of exocrine function make DPPHR a more favorable approach than PPPD for patients with chronic pancreatitis. SN - 1555-9823 UR - https://www.unboundmedicine.com/medline/citation/26350671/Long_term_Outcomes_Favor_Duodenum_preserving_Pancreatic_Head_Resection_over_Pylorus_preserving_Pancreaticoduodenectomy_for_Chronic_Pancreatitis:_A_Meta_analysis_and_Systematic_Review_ L2 - https://www.ingentaconnect.com/openurl?genre=article&amp;issn=0003-1348&amp;volume=81&amp;issue=9&amp;spage=909&amp;aulast=Sukharamwala DB - PRIME DP - Unbound Medicine ER -