Pylorus-preserving total pancreatectomy for pancreatic cancer

Standard total pancreatectomy (TP) combined with gastric resection often re sults in uncontrollable diabetes and malnutrition. Pylorus-preserving total pancreatectomy (PPTP) and standard TP for pancreatic cancer were compared in terms of operative outcomes, nutritional recovery, and long-term surviva l, Twenty-four patients with pancreatic ductal adenocarcinoma (n = 14) or i ntraductal papillary mucinous carcinoma (N = 10) underwent PPTP (n = 10) or standard TP (n = 14). There were no significant differences in age, gender , or tumor type or stage between the PPTP and standard TP groups. Early (wi thin 30 days of surgery) morbidity and mortality rates were 20% and 0% for PPTP and 29% and 7% for standard TP, respectively. Delayed gastric emptying occurred in 2 patients in each group. The incidence of late complications, including uncontrollable diabetes, diarrhea, and malnutrition, tended to b e lower after PPTP (30%) than after standard TP (69%). Serum albumin and bo dy weight at 6 months after surgery were significantly higher in the PPTP t han in the standard TP group. Regardless of the tumor type, long-term survi val did not differ significantly between patients receiving PPTP and those with standard TP. PPTP for pancreatic cancer improves nutritional recovery, without compromising long-term survival, compared with standard TP.