Clinical Effect of Duodenum-Preserving Pancreaticohead Resection And Pancreaticojejunostomy for Pancreatic Head Calculi

Kun SU; Lianmin WANG; Chaoyu MA; Dongfang LIU; Shijun LI; Xianghui WANG; Jinfan LI; Ling ZHANG; Bo LI; Tao WU

doi:10.12259/j.issn.2095-610X.S20230316

Volume 44 Issue 3

Mar. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2023 > 44(3): 103-112

Kun SU, Lianmin WANG, Chaoyu MA, Dongfang LIU, Shijun LI, Xianghui WANG, Jinfan LI, Ling ZHANG, Bo LI, Tao WU. Clinical Effect of Duodenum-Preserving Pancreaticohead Resection And Pancreaticojejunostomy for Pancreatic Head Calculi[J]. Journal of Kunming Medical University, 2023, 44(3): 103-112. doi: 10.12259/j.issn.2095-610X.S20230316

Citation:

Kun SU, Lianmin WANG, Chaoyu MA, Dongfang LIU, Shijun LI, Xianghui WANG, Jinfan LI, Ling ZHANG, Bo LI, Tao WU. Clinical Effect of Duodenum-Preserving Pancreaticohead Resection And Pancreaticojejunostomy for Pancreatic Head Calculi[J]. Journal of Kunming Medical University, 2023, 44(3): 103-112. doi: 10.12259/j.issn.2095-610X.S20230316

Citation:

Kun SU, Lianmin WANG, Chaoyu MA, Dongfang LIU, Shijun LI, Xianghui WANG, Jinfan LI, Ling ZHANG, Bo LI, Tao WU. Clinical Effect of Duodenum-Preserving Pancreaticohead Resection And Pancreaticojejunostomy for Pancreatic Head Calculi[J]. Journal of Kunming Medical University, 2023, 44(3): 103-112. doi: 10.12259/j.issn.2095-610X.S20230316

PDF( 2251 KB)

Clinical Effect of Duodenum-Preserving Pancreaticohead Resection And Pancreaticojejunostomy for Pancreatic Head Calculi

doi: 10.12259/j.issn.2095-610X.S20230316

1.
The Fourth Department of Hepatobiliary and Pancreatic Surgery，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101
2.
Institute of Medical Biology，Chinese Academy of Medical Sciences，Kunming Yunnan 650031，China

Received Date: 2022-10-31
Publish Date: 2023-03-25

Abstract

Abstract

Objective To explore the difference between duodenum-preserving pancreatic head resection （DPPHR） and pancreatic-preserving pancreatic duct jejunostomy （Partington operation） in the treatment of pancreatic head calculus, and evaluate the advantages and disadvantages of the two operations, and optimize and improve them. Methods From January 1, 2017 to October 1, 2022, the clinical, imaging and pathological data of 139 patients with pancreatic head stones requiring surgical treatment admitted to the Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed. According to the different surgical methods, the patients were divided into DPPHR group and Partington group. The clinical characteristics of patients in the two groups and the short-term and long-term outcomes of surgical treatment were analyzed. Results There was no significant difference in preoperative general data （P > 0.05）. Type Ⅰ stones were predominant in DPPHR group （80.2%）, while type Ⅰ and Ⅲ stones were predominant in Partington group （45.3%, 47.2%）, and the difference was statistically significant （ P < 0.001）. In terms of short-term efficacy, DPPHR group had advantages over Partington group in terms of operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rate （ P < 0.05）. In the long-term efficacy, the DPPHR group was better than the Partington group in stone recurrence reoperation and postoperative pancreatic function （ P < 0.05）. Logistic multivariate analysis showed that CP≥5 a （95%CI 1.057-3.884, P = 0.012） and long postoperative drinking history （95%CI 0.987-3.128, P = 0.025）. CP≥5 a and a long history of postoperative alcohol consumption were independent risk factors for survival without pain recurrence after pancreatic head calculi surgery Conclusions Based on the analysis of the short-term efficacy （operation time, intraoperative blood loss, postoperative hospital stay and postoperative complication rate） and long-term efficacy （stone recurrence and reoperation, postoperative pancreatic function） of patients with pancreatic head calculi in this study, DPPHR surgery was superior to Partington surgery, suggesting that DPPHR surgery has become an effective treatment for PDS at present. However, it is also necessary to develop an individualized surgical strategy for the patient, with emphasis on postoperative care and follow-up to provide the best outcome for the patient.
- DPPHR,
- Partington,
- Chronic pancreatitis,
- Pancreatic head stone

FullText(HTML)

References(22)

References

[1]	Talukdar R,Unnisa M. Optimizing nutrition in chronic pancreatitis[J]. Curr Opin Gastroenterol,2022,38(5):495-500. doi: 10.1097/MOG.0000000000000866
[2]	Bundred J,Thakkar R G,Pandanaboyana S. Systematic review of sarcopenia in chronic pancreatitis: prevalence,impact on surgical outcomes,and survival[J]. Expert Rev Gastroenterol Hepatol,2022,16(7):665-672. doi: 10.1080/17474124.2022.2091544
[3]	Okazaki K,Kawa S,Kamisawa T,et al. Amendment of the Japanese consensus guidelines for autoimmune pancreatitis,2020[J]. J Gastroenterol,2022,57(4):225-245. doi: 10.1007/s00535-022-01857-9
[4]	Khan M N,Raza S S,Hussain A K,et al. Pancreatic duct stones[J]. J Ayub Med Coll Abbottabad,2017,29(1):154-156.
[5]	Büchler M W,Friess H,Bittner R,et al. Duodenum-preserving pancreatic head resection: Long-term results[J]. J Gastrointest Surg,1997,1(1):13-19. doi: 10.1007/s11605-006-0004-z
[6]	Beger H G,Mayer B,Poch B. Duodenum-preserving pancreatic head resection: A local parenchyma-sparing treatment of benign and premalignant tumors of the pancreatic head[J]. Chirurg,2019,90(9):736-743. doi: 10.1007/s00104-019-0942-0
[7]	Beger H G,Mayer B. Duodenum-preserving pancreatic head resection in chronic pancreatitis: Limitations of the Heidelberg multicenter ChroPac study[J]. Chirurg,2018,89(5):392-396. doi: 10.1007/s00104-018-0615-4
[8]	Boni L,Huo B,Alberici L,et al. EAES rapid guideline: updated systematic review,network meta-analysis,CINeMA and GRADE assessment,and evidence-informed European recommendations on the management of common bile duct stones[J]. Surg Endosc,2022,36(11):7863-7876. doi: 10.1007/s00464-022-09662-4
[9]	沈磊,杨自轩,丁睿博,等. 胰管结石诊治进展[J]. 中华肝胆外科杂志,2022,28(4):317-320. doi: 10.3760/cma.j.cn113884-20211108-00360
[10]	Jeon C Y,Chen Q,Yu W,et al. Identification of individuals at increased risk for pancreatic cancer in a community-based cohort of patients with suspected chronic pancreatitis[J]. Clin Transl Gastroenterol,2020,11(4):e00147. doi: 10.14309/ctg.0000000000000147
[11]	Beyna T,Neuhaus H,Gerges C. Endoscopic treatment of pancreatic duct stones under direct vision: Revolution or resignation? Systematic review[J]. Dig Endosc,2018,30(1):29-37. doi: 10.1111/den.12909
[12]	Adler J M,Gardner T B. Endoscopic therapies for chronic pancreatitis[J]. Dig Dis Sci,2017,62(7):1729-1737. doi: 10.1007/s10620-017-4502-5
[13]	Farkas G,Leindler L,Daróczi M,et al. Prospective randomised comparison of organ-preserving pancreatic head resection with pylorus-preserving pancreaticoduodenectomy[J]. Langenbecks Arch Surg,2006,391(4):338-342. doi: 10.1007/s00423-006-0051-7
[14]	Busquets J,Martín S,Secanella L,et al. Delayed gastric emptying after classical Whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial[J]. Langenbecks Arch Surg,2022,407(6):2247-2258. doi: 10.1007/s00423-022-02583-9
[15]	Keck T,Adam U,Makowiec F,et al. Short- and long-term results of duodenum preservation versus resection for the management of chronic pancreatitis: a prospective,randomized study[J]. Surgery,2012,152(3):S95-S102. doi: 10.1016/j.surg.2012.05.016
[16]	Boregowda U,Echavarria J,Umapathy C,et al. Endoscopy versus early surgery for the management of chronic pancreatitis: a systematic review and meta-analysis[J]. Surg Endosc,2022,36(12):8753-8763. doi: 10.1007/s00464-022-09425-1
[17]	Guzmán-Calderón E,Martinez-Moreno B,Casellas J A,et al. Per-oral pancreatoscopy-guided lithotripsy for the endoscopic management of pancreatolithiasis: A systematic review and meta-analysis[J]. J Dig Dis,2021,22(10):572-581. doi: 10.1111/1751-2980.13041
[18]	Zhao X,Cui N,Wang X,et al. Surgical strategies in the treatment of chronic pancreatitis: An updated systematic review and meta-analysis of randomized controlled trials[J]. Medicine (Baltimore),2017,96(9):e6220.
[19]	McCarty T R,Sobani Z,Rustagi T. Per-oral pancreatoscopy with intraductal lithotripsy for difficult pancreatic duct stones: a systematic review and meta-analysis[J]. Endosc Int Open,2020,8(10):E1460-E1470. doi: 10.1055/a-1236-3187
[20]	Gerges C,Pullmann D,Schneider M,et al. Pancreatoscopy in endoscopic treatment of pancreatic duct stones: a systematic review[J]. Minerva Chir,2019,74(4):334-347.
[21]	Malka D,Hammel P,Sauvanet A,et al. Risk factors for diabetes mellitus in chronic pancreatitis[J]. Gastroenterology,2000,119(5):1324-1332. doi: 10.1053/gast.2000.19286
[22]	Ueda J,Miyasaka Y,Ohtsuka T,et al. Short- and long-term results of the Frey procedure for chronic pancreatitis[J]. J Hepatobiliary Pancreat Sci,2015,22(3):211-216. doi: 10.1002/jhbp.176

Relative Articles(20)

Relative Articles

[1]	Liu-zheng LI, Wei-wen SHEN, Xue WANG, Lei-sheng XU, Jia-wei FENG, Jun-feng WANG. Clinical Application of Modified Beger Operation. Journal of Kunming Medical University, 2021, 42(2): 113-117. doi: 10.12259/j.issn.2095-610X.S20210231
[2]	Fan NI, Zheng-cheng YE, Zhi-tang GUO, Ying-nan LI, Guang ZHAI, Chao ZHONG, Ke-jia LI, Xiao-xing CHEN, Dong WEI, Xue-song WU, Ren-chao ZOU, Jia-yun GE. Application of Emergency Pancreaticoduodenectomy in the Treatment of Blunt Duodenal and Pancreatic Trauma. Journal of Kunming Medical University, 2020, 41(11): 88-92. doi: 10.12259/j.issn.2095-610X.S20201108
[3]	Li Si Wei , Wang Su Bin , Zhou Jiang Fan , Zhang Ming Qian , Gu Song Tao , Yang Ming Dong , Yang Rui , Yi Jing Shuai , Zhang Zhi Hua . . Journal of Kunming Medical University, 2018, 39(10): 7-12.
[4]	Pan Rui , Shi Hong , Yang Xiao Juan . The Effect of Early Nasal Jejunum Nutrition on the Inflammatory Markers of Severe Acute Pancreatitis. Journal of Kunming Medical University, 2018, 39(01): 100-103.
[5]	Li Li Ping , Wang Guan Shun , Ma Jian , Chen Di , Ding Ying Ying . The Value of MRI Apparent Diffusion Coefficient in Interstitial Edema Pancreatitis and Acute Necrotizing Pancreatitis. Journal of Kunming Medical University, 2018, 39(04): 79-82.
[6]	Liu Bao Zhi , Zhang Sheng Ning , Liu Jian , Li Wang , Liu Jing , Li Lai Bang . . Journal of Kunming Medical University, 2018, 39(12): 54-60.
[7]	Pu Xiao Kai , Lu Qi Yu . Effect of Octreotide for Patients with Acute Pancreatitis and Its Influence on the Pancreatic Blood Flow. Journal of Kunming Medical University, 2017, 38(09): 83-86.
[8]	Gu Yong Fang . Long-term Effects of Palliative Surgery and Pancreaticoduodenectomy in Treatment of Pancreatic Cancer and Ampulla Surrounding Cancer. Journal of Kunming Medical University,
[9]	Lu Rong . . Journal of Kunming Medical University,
[10]	Li Xiao Tao . . Journal of Kunming Medical University,
[11]	Wang Wei . . Journal of Kunming Medical University,
[12]	Liu Zhi Heng . . Journal of Kunming Medical University,
[13]	Li Xiao Kai . . Journal of Kunming Medical University,
[14]	Zhang Lei . . Journal of Kunming Medical University,
[15]	Feng Yong Shun . . Journal of Kunming Medical University,
[16]	Zhang Xin Jun . . Journal of Kunming Medical University,
[17]	. Laparoscopic Pancreatoduodenectomy in One Patient. Journal of Kunming Medical University,
[18]	. Clinical Analysis of Pancreatoduodenectomy in 48 Patients. Journal of Kunming Medical University,
[19]	Cheng Si Gen . . Journal of Kunming Medical University,
[20]	Diao Chang . . Journal of Kunming Medical University,