S. Takao et al., Comparison of relapse and long-term survival between pylorus preserving and whipple pancreaticoduodenectomy in periampullary cancer, AM J SURG, 176(5), 1998, pp. 467-470
BACKGROUND: Whether long-term survival and type of recurrence in periampull
ary cancer are influenced by the type of surgical procedure or not is still
obscure. The purpose of this review was to analyze the results at a single
institution.
METHODS: Between 1982 and 1996, 113 consecutive patients with either distal
bile duct or ampullary cancers underwent either pylorus-preserving pancrea
ticoduodenectomy (PPPD) or the Whipple procedure. The median follow-up was
30 months (range 12 to 150). Patient records were reviewed to determine typ
e of recurrence and survival.
RESULTS: In distal bile duct or ampullary cancers, comparison of actuarial
survival curves between PPPD and the Whipple operation revealed no signific
ant differences. Even in node-positive patients, the 5-year survival rates
did not differ significantly between those undergoing PPPD or the Whipple o
peration. Tumor recurrence was not correlated with the operative method, al
though among types of tumor recurrence, the rate of blood-borne metastasis
was higher in distal bile duct or ampullary cancers.
CONCLUSIONS: PPPD is an acceptable alternative to the Whipple procedure in
the treatment of periampullary cancer. Long-term survival and type of recur
rence were not influenced by these types of surgical procedures. Am J Surg.
1998; 176:467-470. (C) 1998 by Excerpta Medica, Inc.