Postoperative Nutritional Status after Pancreatoduodenectomy with Total Stomach Preservation and Selective Proximal Vagotomy or Whipple's Procedure

Yozo Watanabe, Hidenori Tsumura, Toshiyuki Nakagawa, Hideki Sakurai, Ryoichi Akimoto, Toshio Morimoto, Hiroshi Aonuma¹⁾, Seiichi Ono¹⁾, Koichi Sato¹⁾, Noburu Sakakibara¹⁾, Noboru Azuma²⁾

Department of Surgery, Izunagaoka Hospital, Juntendo University School of Medicine
¹⁾First Department of Surgery, Juntendo University School of Medicine
²⁾Department of Surgery, Misato Junshin Hospital

We have treated diseases involving the head of the pancreas by pancreatoduodenectomy with total stomach preservation and selective proximal vagotomy. In the present study, the postoperative nutritional state of patients treated by this technique was compared with that of patients receiving Whipple's pancreatoduodenectomy. A total of 16 patients were admitted to this study, of whom 8 had received total stomach preservation and 8 had undergone Whipple's operation 1 year or more previously. For nutritional assessment, the body weight, triceps thickness, protein and fat levels, immunological parameters, vitamins and trace elements, and hormone levels were measured. A nutritional index was then calculated from the results of such measurements. We found a significant grouprelated difference or a tendency to such a difference in the ratio of the preoperative and standard weights to the current weight, the prealbumin and retionol-bound protein levels, the PHA lymphocyte blastogenesis test, the blood levels of zinc and T₃, and the nutritional index. Better results were obtained by total stomach preservation. These results suggest that total stomach preservation is superior to Whipple's procedure from the standpoint of postoperative nutrition.

Key words
postoperative nutritional status after pancreatoduodenectomy, pancreatoduodenectomy with total stomach preservation and selective proximal vagotomy, whipple's pancreatoduodenectomy

Reprint requests
Yozo Watanabe Department of Surgery, Izunagaoka Hospital, Juntendo University School of Medicine
1129 Nagaoka, Izunagaoka, Tagata-gun, Shizuoka, 410-22 JAPAN

Accepted
October 9, 1991

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