Duodenum-preserving resection of the head of the pancreas: The future

In a randomized unicenter clinical study duodenum-preserving pancreatic head resection and pylorus-preserving Whipple operation were prospectively compared in patients with chronic pancreatitis. Preoperatively, 10 days and 6 head resectionmonths postoperatively the patients were investigated with regard to glucose tolerance, pain relief, weight gain, hospital readmission, professional rehabilitation and postoperative complications. In the 6 months’ follow-up, patients who underwent the duodenum-preserving pancreatic head resection had less pain, greater weight gain, a better glucose tolerance and a higher insulin secretion capacity than patients with the pylorus-preserving Whipple resection. The postoperative mortality was zero and the postoperative morbidity was comparable in both groups (duodenum-preserving pancreatic head resection; 3/20 patients (15%), pylorus-preserving Whipple operation 4/20 patients (20%)). Duodenum-preserving pancreatic head resection provides a better postoperative outcome than the pylorus-preserving Whipple resection. Therefore, it should be considered as a new standard operation in patients with chronic pancreatitis and pancreatic head-related complications.