DELAYED GASTRIC-EMPTYING OCCURS AFTER PYL ORUS-PRESERVING WHIPPLE, BUT NOT AFTER DUODENUM-PRESERVING PANCREATIC HEAD RESECTION IN PATIENTS WITH CHRONIC-PANCREATITIS

In a prospective randomized controlled unicenter trial we compared the pylorus-preserving Whipple (PW) with the duodenum-preserving pancreat ic head resection (DPPHR) in chronic pancreatitis, with regard to post operative gastric emptying, CCK serum levels and parameters of quality of life. Gastric emptying and CCK serum levels were measured by parac etamol absorption and test meal stimulation. Ten patients with chronic pancreatitis were enrolled in each group. Both groups were well balan ced with regard to sex, age and indication for surgery. The paracetamo l absorption showed no statistical difference between a control group consisting of 6 healthy volunteers and the patients with chronic pancr eatitis. Ten days postoperatively gastric emptying showed a statistica lly significant reduction in the PW-group but not in the DPPHR-group c ompared with the preoperatve findings. After 6 months gastric emptying was increased to control levels. The CCK levels showed a trend of red uction 10 days postoperative after PW. The DPPHR-group showed a tenden cy for better weight increase 6 months postoperatively. 60 % of the pa tients in boths groups were pain-free, but in the PW group one patient still suffered from severe daily pain. In summary, early after PW a d elayed gastric emptying ocurrs, but without major clinical relevance. The DPPHR shows a tendency for faster reconvalecence, better weight ga in and pain relief compared with the PW.