Comparison between Whipple pancreatico-duodenectomy and pylorus-preserving pancreatico-duodenectomy for pancreatic and peri-ampullary carcinoma

Between 1993 and 2001, 34 patients underwent Whipple pancrcaticoduodenectomy (WPD) and 28 underwent pylorus-preserving pancreaticoduodenectomy (PPPD); for pancreatic adenocarcinoma (n=39) and periampullary carcinoma (n=23). This prospective study was conducted to compare between these two procedures regarding operative outcome, nutritional recovery and long-term survival. Both groups were similar regarding age, sex, clinical presentation, laboratory data, tumor stage and grade. There were no significant differences between both groups in mortality or morbidity, duration of gastric aspiration and time to start solid meals. Patients who underwent PPPD had better nutritional recovery (P<0.05). Multivariate analysis showed that type of operation, age and sex were not significant indicators of survival in contrast to radicality of operation, tumor stage and grade.