Indications and Results of Pylorus-preserving Pancreatoduodenectomy for Invasive Ductal Adenocarcinoma of the Head of the Pancreas

Takashi Hatori, Toshihide Imaizumi, Nobuhiko Harada, Akira Fukuda and Ken Takasaki

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University

This study was undertaken to evaluate the indications and results of pylorus-preserving pancreatoduodenectomy (PpPD) for invasive ductal adenocarcinoma of the head of the pancreas. A total of 154 patients underwent radical resection from 1989 when we performed PpPD for invasive ductal adenocarcinoma of the head of the pancreas under the following indications; no tumor invasion in the first portion of the duodenum or stomach and no lymph node metastasis around the stomach (No. (3), (4), (5), (6), (7)),were analyzed in this study and divided into two groups, those who had PpPD (n=66), and those who had pancreatoduodenectomy with partial gastrectomy (PD, n=88). The extended radical operation was performed in about 80% of patients in both groups, safely. There were no statistically significant difference between PpPD and PD in tumor staging and curability. The 5-year survival rate and mean survival time in PpPD patients was 35% and 15.0 months, respectively. Retroperitoneal tumor recurrence or liver metastasis was seen in patients of both groups, but lymph node recurrence surrounding stomach was not seen in PpPD patients. Postoperative quality of life (QOL) in patients who survived more than one year was good in both groups. It was concluded that in accordance with our criteria of indications, PpPD could be performed as a standard operation for ductal adenocarcinoma of the head of the pancreas.

Key words
pancreatic head cancer, pylorus-preserving pancreatoduodenctomy, extended radical operation

Reprint requests
Takashi Hatori Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 JAPAN

Accepted
July 28, 1999

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