Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR?

Koji Yamaguchi, Kazunori Yokohata, Kenji Nakano, Kazuhiro Ohtani, Yoshiaki Ogawa, Kazuo Chijiiwa, Masao Tanaka

    Research output: Contribution to journalArticle

    38 Citations (Scopus)

    Abstract

    Less invasive pancreatic head resection, such as pylorus preserving pancreatoduodenectomy (PPPD) and duodenum preserving pancreatic head resection (DPPHR) has been introduced for the treatment of pancreatoduodenal lesions, especially for benign conditions, in consideration of postoperative quality of life. Surgical stress and exocrine and endocrine function of the residual pancreas were examined in 44 patients with PPPD, 10 with conventional pancreatoduodenectomy (PD) and six with DPPHR. Clinical findings including serum levels of C reactive protein (CRP), fasting blood sugar, a 120-min value of the 75-g oral glucose tolerance test (OGTT), N-benzol-L-tyrosyl-p-aminobenzoic acid (BT-PABA) excretion value (a pancreatic exocrine function test), and volume of postoperative pancreatic juice drainage were compared among the three different variants of pancreatectomy. Operation time and operative blood loss in PD were largest of the three, followed by PPPD and DPPHR. Postoperative elevation of serum CRP on postoperative day (POD) 2 or 3 was similar among the three different types of operation. Fasting blood sugar concentrations were not different among the three groups at short- and long-term after the operation, while the 120-min value of the GTT showed a marked elevation at long-term only after PPPD. The volume of pancreatic juice drainage increased up to POD 4 and became constant thereafter. The total amount of pancreatic juice drainage from POD 4 to 13 was smallest in PD (637 ml) followed by PPPD (1255 ml) and DPPHR (1431 ml). The BT-PABA value declined after PD (-20.3%, P = 0.0437) and PPPD (-20.2%, P = 0.0239) at short term, but not after DPPHR (8.2%). These findings suggest that the early impairment of the pancreatic exocrine function after PD and PPPD but not after DPPHR may indicate that the invasiveness of pancreatic head resection to the pancreatic functions is greater in PD and PPPD than in DPPHR.

    Original languageEnglish
    Article number300298
    Pages (from-to)282-288
    Number of pages7
    JournalDigestive Diseases and Sciences
    Volume46
    Issue number2
    DOIs
    Publication statusPublished - Jan 1 2001

    Fingerprint

    Pancreaticoduodenectomy
    Pylorus
    Duodenum
    Pancreatic Juice
    4-Aminobenzoic Acid
    Drainage
    Benzene
    C-Reactive Protein
    Blood Glucose
    Fasting
    Pancreatic Function Tests
    Pancreatectomy
    Glucose Tolerance Test
    Operative Time
    Blood Proteins
    Pancreas

    All Science Journal Classification (ASJC) codes

    • Physiology
    • Gastroenterology

    Cite this

    Yamaguchi, K., Yokohata, K., Nakano, K., Ohtani, K., Ogawa, Y., Chijiiwa, K., & Tanaka, M. (2001). Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR? Digestive Diseases and Sciences, 46(2), 282-288. [300298]. https://doi.org/10.1023/A:1005644614104

    Which is a less invasive pancreatic head resection : PD, PPPD, or DPPHR? / Yamaguchi, Koji; Yokohata, Kazunori; Nakano, Kenji; Ohtani, Kazuhiro; Ogawa, Yoshiaki; Chijiiwa, Kazuo; Tanaka, Masao.

    In: Digestive Diseases and Sciences, Vol. 46, No. 2, 300298, 01.01.2001, p. 282-288.

    Research output: Contribution to journalArticle

    Yamaguchi, K, Yokohata, K, Nakano, K, Ohtani, K, Ogawa, Y, Chijiiwa, K & Tanaka, M 2001, 'Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR?', Digestive Diseases and Sciences, vol. 46, no. 2, 300298, pp. 282-288. https://doi.org/10.1023/A:1005644614104
    Yamaguchi K, Yokohata K, Nakano K, Ohtani K, Ogawa Y, Chijiiwa K et al. Which is a less invasive pancreatic head resection: PD, PPPD, or DPPHR? Digestive Diseases and Sciences. 2001 Jan 1;46(2):282-288. 300298. https://doi.org/10.1023/A:1005644614104
    Yamaguchi, Koji ; Yokohata, Kazunori ; Nakano, Kenji ; Ohtani, Kazuhiro ; Ogawa, Yoshiaki ; Chijiiwa, Kazuo ; Tanaka, Masao. / Which is a less invasive pancreatic head resection : PD, PPPD, or DPPHR?. In: Digestive Diseases and Sciences. 2001 ; Vol. 46, No. 2. pp. 282-288.
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    abstract = "Less invasive pancreatic head resection, such as pylorus preserving pancreatoduodenectomy (PPPD) and duodenum preserving pancreatic head resection (DPPHR) has been introduced for the treatment of pancreatoduodenal lesions, especially for benign conditions, in consideration of postoperative quality of life. Surgical stress and exocrine and endocrine function of the residual pancreas were examined in 44 patients with PPPD, 10 with conventional pancreatoduodenectomy (PD) and six with DPPHR. Clinical findings including serum levels of C reactive protein (CRP), fasting blood sugar, a 120-min value of the 75-g oral glucose tolerance test (OGTT), N-benzol-L-tyrosyl-p-aminobenzoic acid (BT-PABA) excretion value (a pancreatic exocrine function test), and volume of postoperative pancreatic juice drainage were compared among the three different variants of pancreatectomy. Operation time and operative blood loss in PD were largest of the three, followed by PPPD and DPPHR. Postoperative elevation of serum CRP on postoperative day (POD) 2 or 3 was similar among the three different types of operation. Fasting blood sugar concentrations were not different among the three groups at short- and long-term after the operation, while the 120-min value of the GTT showed a marked elevation at long-term only after PPPD. The volume of pancreatic juice drainage increased up to POD 4 and became constant thereafter. The total amount of pancreatic juice drainage from POD 4 to 13 was smallest in PD (637 ml) followed by PPPD (1255 ml) and DPPHR (1431 ml). The BT-PABA value declined after PD (-20.3{\%}, P = 0.0437) and PPPD (-20.2{\%}, P = 0.0239) at short term, but not after DPPHR (8.2{\%}). These findings suggest that the early impairment of the pancreatic exocrine function after PD and PPPD but not after DPPHR may indicate that the invasiveness of pancreatic head resection to the pancreatic functions is greater in PD and PPPD than in DPPHR.",
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    AU - Chijiiwa, Kazuo

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