• Tsutomu Fujii, Mitsuro Kanda, Yasuhiro Kodera, Shunji Nagai, Tevfik T Sahin, Akiyuki Kanzaki, Suguru Yamada, Hiroyuki Sugimoto, Shuji Nomoto, Satoshi Morita, Shin Takeda, and Akimasa Nakao.
• Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan. fjt@med.nagoya-u.ac.jp
• Pancreas. 2011 Nov 1; 40 (8): 1258-63.

ObjectiveThe aim of this study was to investigate the clinical benefits of pancreatic head resection with segmental duodenectomy (PHRSD) with a particular emphasis on the long-term outcome.MethodsA retrospective analysis of PHRSD (77 patients) and pylorus-preserving pancreatoduodenectomy (PPPD; 55 patients) was performed for benign and low-grade malignant neoplasms of the pancreatic head. The zintraoperative and postoperative courses and long-term nutritional statuses were compared.ResultsThe mean operative time and blood loss were significantly less in the PHRSD group than in the PPPD group (351 vs 395 minutes, P = 0.005; and 474 vs 732 mL, P < 0.0001, respectively). Fewer overall postoperative complications occurred in the PHRSD group than in the PPPD group (33.8% vs 52.7%, respectively, P = 0.03). Postoperative weight loss and changes in the serum total protein and albumin levels were significantly milder in the PHRSD group than in the PPPD group (P = 0.04, P = 0.04, and P = 0.046, respectively). The overall recurrence-free survival rates in patients with noninvasive intraductal papillary mucinous neoplasms were equivalent in both groups.ConclusionsThe present results suggest that PHRSD fulfills the operative safety, long-term nutritional status, and curative goals and could be the best option for patients with benign or low-grade malignant pancreatic lesions.

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