Decreased morbidity and mortality after pancreatoduodenectomy

Pierce A. Grace, Henry A. Pitt, Ronald K. Tompkins, Lawrence DenBesten, William P. Longmire

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Abstract

In two 5 year periods (1975 to 1979 and 1980 to 1984), 96 patients underwent pancreatoduodenal resection, which included 74 partial pancreatic resections and 22 total pancreatectomies. Thirty-seven of these patients had resections with preservation of the pylorus. Substantial reductions in perioperative mortality (2 percent versus 10 percent) and morbidity (26 percent versus 49 percent) (p < 0.05) were achieved in the latter period. Pylorus preservation, with a mortality and morbidity of 3 percent and 27 percent, respectively, did not increase operative risk or compromise long-term survival in patients with malignant disease. In comparison, relatively high mortality and morbidity rates (14 percent and 59 percent) accompanied total pancreatectomy without improved long-term survival. Five year actuarial survival for nonpancreatic periampullary adenocarcinomas was 58 percent. Thus, we recommend pancreatoduodenectomy with preservation of the pylorus for resection of perimpullary tumors. These patients, whose only possibility for cure is a major pancreatic resection, should not be denied this opportunity on the basis of reports from a previous era.

Original languageEnglish (US)
Pages (from-to)141-149
Number of pages9
JournalThe American Journal of Surgery
Volume151
Issue number1
DOIs
StatePublished - Jan 1986

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ASJC Scopus subject areas

  • Surgery

Cite this

Grace, P. A., Pitt, H. A., Tompkins, R. K., DenBesten, L., & Longmire, W. P. (1986). Decreased morbidity and mortality after pancreatoduodenectomy. The American Journal of Surgery, 151(1), 141-149. https://doi.org/10.1016/0002-9610(86)90024-3