Short- and long-term outcomes of pancreatectomy with or without biliary tract and duodenum preservation for benign and borderline neoplasms

Dig Surg. 2014;31(3):233-41. doi: 10.1159/000365294. Epub 2014 Sep 30.

Abstract

Objectives: The aim of this study was to compare short- and long-term outcomes of biliary tract and duodenum-preserving pancreatectomy (BT-DPP) versus non-conservative pancreatectomy (NCP).

Patients and methods: From 2008 to 2012, 39 of 259 patients underwent pancreatectomy for benign or borderline neoplasms. Patients were classified as BT-DPP (n = 15) or NCP (n = 24). Data were prospectively collected and retrospectively analyzed on an intention-to-treat basis.

Results: Both groups were comparable regarding demography, intra- and postoperative data (operative time, blood loss) and length of hospital stay. Overall complications occurred in 10 and 19 (p = 0.31), postpancreatectomy fistula in 2 and 4 (p = 0.6), biliary fistula in 3 and 1 (p = 0.15), and postpancreatectomy hemorrhage in 3 and 7 (p = 0.4) patients in the BT-DPP and NCP groups, respectively. One patient in the NCP group died. The median follow-up was 27 (4.4-56.5) and 23.4 (0.3-53) months in the BT-DPP and NCP groups, respectively. One BT-DPP patient had biliary stenosis treated endoscopically and 1 patient in the NCP group required surgery. The incidence of diabetes was equal.

Conclusion: Our study shows that BT-DPP is feasible without an increase in morbidity compared with NCP. In the long term, BT-DPP was not associated with higher morbidity.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biliary Tract
  • Cohort Studies
  • Disease-Free Survival
  • Duodenum
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Organ Sparing Treatments / methods*
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • Treatment Outcome