Standard whipple's operation versus pylorus preserving pancreaticoduodenectomy: a randomized controlled trial study

Abstract

Objective: A single-institution randomized controlled trial was conducted to compare the results of standard whipple operation (SW) with those of pylorus-preserving pancreaticoduodenectomy (PPPD).

Material and method: Between January 2000 and December 2004, 27 patients with pancreatic or periampullary adenocarcinoma were enrolled into the study. All patients were randomly allocated to either a SW or a PPPD resection. Patients' characteristics, postoperative mortality and morbidity, and survival up to two years were compared.

Results: There were no significant differences in baseline characteristics between the two groups of patients. There were also no significant differences in blood loss and operative time. Delayed gastric emptying (DGE) occurred more frequently in the PPPD group, but other operative complications, hospital mortality, and the length of hospital stay were similar for the two groups. There were no significant survival differences at two years after operation.

Conclusions: SW and PPPD were comparable in terms of operation time, blood loss, operative mortality and morbidity, and survival. Although the incidence of DGE was higher in the PPPD group, the hospital stay was similar for both groups. Both surgical procedures were equally effective for the treatment of pancreatic and periampullary carcinoma.