Prospective randomized study to evaluate quality of life after partial pancreatoduodenectomy according to Whipple versus pylorus preserving pancreatoduodenectomy according to Longmire-Traverso for periampullary carcinoma

Background: Survival and quality of life of patients are the decisive endpo ints in the treatment of malignant disease. Methods: In a prospective randomized trial 44 patients with periampullary c arcinoma of stages cT1-4, cN0-1, cM0 were assigned to either classic partia l pancreatoduodenectomy according to Whipple (PD) or to pylorus preserving pancreatoduodenectomy according to Longmire-Traverso (PPPD), in order to ev aluate the impact of the surgical procedure on quality of life. Main endpoi nt of this study was quality of life, which was assessed with the EORTC-que stionnaire. Results: Except for loss of appetite and loss of body weight, which was fel t less incommodating after PPPD, no significant differences were observed b etween the groups during median follow-up of 18 months (12 to 30). Especial ly physis, ability to work, cognitive, emotional and social functioning did not differ significantly. Conclusion: Improvement of quality of life due to preservation of the stoma ch and proximal duodenum is not an argument in favor of PPPD.