Conventional and Pylorus Preserving Pancreatoduodenectomy for Invasive Ductal Pancreatic Cancer

Tomoo Kosuge, Kazuaki Shimada, Junji Yamamoto and Susumu Yamasaki

Department of Surgery, National Cancer Center Hospital

Pylorus-preserving pancreatoduodenectomy (PpPD) was applied to selected patients with ductal pancreatic cancer. Criteria for indication included distant location of the lesion from the pyloric region, no or minimal involvement of regional lymph nodes, and high age and/or poor general condition of the patient. Results of PpPD (N=9) was compared with those of classical PD perfermed in the period between 1980 and 1989 (early PD: N=16) and of extended PD performed between 1990 and 1997 (late PD: N=54). The proportion of advanced disease was larger in late PD than the others. Stage distribution was similar in PpPD and early PD. Lower mortality and higher survival rate were observed in PpPD, late PD, and early PD in that order. Although the background of each patient group was different, the application of PpPD to less advanced pancreatic cancer was justified.

Key words
pancreatic cancer, pylorus-preserving pancreatoduodenectomy, pancreatic resection

Reprint requests
Tomoo Kosuge Department of Surgery, National Cancer Center Hospital 5-1-1 Tsukiji, Chuou-ku Tokyo, 104-0045 JAPAN

Accepted
July 28, 1999

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