A comparison of the long-term functional outcomes of standard pancreatoduodenectomy and pylorus-preserving pancreatoduodenectomy

Abstract

Background/aims: We compared the long-term functional outcomes of standard pancreatoduodenectomy (SPD) and pylorus-preserving pancreatoduodenectomy (PPPD) patients.

Methodology: The subjects were 67 patients who underwent SPD (23) or PPPD (44) and who survived more than 3 years. General nutritional status, pancreatic functions, gastrointestinal (GI) symptoms, and quality of life (QOL) were assessed.

Results: Postoperative relative body weights to preoperative body weight in the SPD group were generally lower, however, no significant difference was observed throughout the postoperative period, except at 6 postoperative months. Steatorrhea developed in 3 (13.0%) of the 23 SPD and in 6 (13.6%) of the 44 PPPD patients during the 3-year follow-up (p > 0.05). IFG or DM newly developed in 2 (10.5%) of the 19 SPD and in 5 (13.9%) of the 36 PPPD patients during the 3-year follow-up (p > 0.05). Symptoms such as flatus, diarrhea and fatigue were more frequently observed in SPD patients. The general health status/QOL score of the PPPD group (75.5) was somewhat higher than that of the SPD group (65.4) (p > 0.05).

Conclusions: The long-term functional outcomes of SPD and PPPD patients were generally comparable. However, PPPD was more favorable than SPD in terms of an earlier postoperative recovery and reduced rates of GI symptoms such as flatus and diarrhea.