Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1983 Jan;197(1):68–71.

Pancreaticoduodenectomy for benign disease.

J R Cohen, N Kuchta, N Geller, G T Shires, P Dineen
PMCID: PMC1352856  PMID: 6848056

Abstract

Ten cases of pancreaticoduodenectomy (PD) performed for benign disease are reported with all patients alive and well at an average of 7.5 years. A review of the English literature reveals that 52 patients have had a PD for benign disease in which a carcinoma had originally been suspected (incidence of 1%) with an overall surgical mortality of 9.6%. Three hundred and thirty-four cases of PD done for complications of pancreatitis have been reported with an overall mortality of 4.8%. On rare occasion, despite extensive preoperative evaluation, a patient will be explored with true uncertainty as to the diagnosis of a periampullary mass. Under these circumstances, it has been considered good surgical judgement to proceed with resection, considering that the lesion may be benign, as opposed to leaving behind an early resectable malignant lesion. Results of this review support this policy only in that if the PD is done for what turns out to be benign disease, the perioperative mortality is low, and an excellent long-term survival can be expected.

Full text

PDF
71

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ASADA S., ITAYA H., NAKAMURA K., ISOHASHI T., MASUOKA S. RADICAL PANCREATODUODENECTOMY AND PORTAL VEIN RESECTION. REPORT OF TWO SUCCESSFUL CASES WITH TRANSPLANTATION OF PORTAL VEIN. Arch Surg. 1963 Oct;87:609–613. doi: 10.1001/archsurg.1963.01310160071012. [DOI] [PubMed] [Google Scholar]
  2. Aston S. J., Longmire W. P., Jr Pancreaticoduodenal resection. Twenty years' experience. Arch Surg. 1973 Jun;106(6):813–817. doi: 10.1001/archsurg.1973.01350180047015. [DOI] [PubMed] [Google Scholar]
  3. Aston S. J., Longmire W. P., Jr Pancreaticoduodenal resection. Twenty years' experience. Arch Surg. 1973 Jun;106(6):813–817. doi: 10.1001/archsurg.1973.01350180047015. [DOI] [PubMed] [Google Scholar]
  4. BOWDEN L. The fallibility of pancreatic biopsy. Ann Surg. 1954 Apr;139(4):403–408. doi: 10.1097/00000658-195404000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. BRIGGS J. D., JORDAN P. H., Jr, LONGMIRE W. P., Jr Experience with resection of the pancreas in the treatment of chronic relapsing pancreatitis. Ann Surg. 1956 Oct;144(4):681–695. doi: 10.1097/00000658-195610000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. BUCKWALTER J. A., LAWTON R. I., TIDRICK R. T. PANCREATODUODENECTOMY. Arch Surg. 1964 Aug;89:331–339. doi: 10.1001/archsurg.1964.01320020095015. [DOI] [PubMed] [Google Scholar]
  7. Bloom P., Steer M. L. Pancreatoduodenectomy. Results when the operation is performed infrequently. Arch Surg. 1975 Dec;110(12):1455–1457. doi: 10.1001/archsurg.1975.01360180025005. [DOI] [PubMed] [Google Scholar]
  8. CARLSON R. I. The problem of diagnosis at the time of operation in tumors of the head of the pancreas. Surgery. 1950 Oct;28(4):672–679. [PubMed] [Google Scholar]
  9. CRAIGHEAD C. C., LIEN R. C. Pancreatoduodenal resection; comments on indications, operative diagnosis, staged procedures, morbid and lethal factors, and survivals. Ann Surg. 1958 Jun;147(6):931–934. [PMC free article] [PubMed] [Google Scholar]
  10. Cattell R. B., Pyrtek L. J. An Appraisal of Pancreatoduodenal Resection: A Follow-up Study of 61 Cases. Ann Surg. 1949 Jun;129(6):840–848. [PMC free article] [PubMed] [Google Scholar]
  11. Child C. G., 3rd, Frey C. F. Pancreaticoduodenectomy. Surgical grand rounds--University of Michigan. Surg Clin North Am. 1966 Oct;46(5):1201–1213. doi: 10.1016/s0039-6109(16)38035-5. [DOI] [PubMed] [Google Scholar]
  12. Christiansen J., Nielsen O. V. Surgical treatment of chronic pancreatitis. Scand J Gastroenterol. 1974;9(6):539–542. [PubMed] [Google Scholar]
  13. Cohen J. R., Kuchta N., Geller N., Shires G. T., Dineen P. Pancreaticoduodenectomy. A 40-year experience. Ann Surg. 1982 May;195(5):608–617. doi: 10.1097/00000658-198205000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Dencker H. Pancreaticoduodenectomy for periampullary tumours. Acta Chir Scand. 1972;138(3):293–300. [PubMed] [Google Scholar]
  15. Frey C. F., Child C. G., Fry W. Pancreatectomy for chronic pancreatitis. Ann Surg. 1976 Oct;184(4):403–413. doi: 10.1097/00000658-197610000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Gatti D. J., O'Brien P. H., Grooms G. A. Analysis of pancreatoduodenectomy. South Med J. 1974 Mar;67(3):278–286. doi: 10.1097/00007611-197403000-00009. [DOI] [PubMed] [Google Scholar]
  17. Gilsdorf R. B., Spanos P. Factors influencing morbidity and mortality in pancreaticoduodenectomy. Ann Surg. 1973 Mar;177(3):332–337. doi: 10.1097/00000658-197303000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Griffin J. M., Starkloff G. B. Surgery of chronic pancreatitis. Am J Surg. 1971 Jul;122(1):18–21. doi: 10.1016/0002-9610(71)90340-0. [DOI] [PubMed] [Google Scholar]
  19. Guillemin G., Cuilleret J., Michel A., Berard P., Feroldi J. Chronic relapsing pancreatitis. Surgical management including sixty-three cases of pancreaticoduodenectomy. Am J Surg. 1971 Dec;122(6):802–807. doi: 10.1016/0002-9610(71)90450-8. [DOI] [PubMed] [Google Scholar]
  20. HILL L. D., STONE C. S., Jr, BAKER J. W. Surgical management of chronic pancreatitis. Am J Surg. 1959 Aug;98(2):304–314. doi: 10.1016/0002-9610(59)90080-7. [DOI] [PubMed] [Google Scholar]
  21. HILST W., KOUCKY C., KAUFMAN L., WILSON G. S. Pancreatoduodenectomy for periampullary carcinoma; an evaluation of technique, mortality, and results. AMA Arch Surg. 1959 May;78(5):738–744. [PubMed] [Google Scholar]
  22. Howard J. M. Pancreatico-duodenectomy: forty-one consecutive Whipple resections without an operative mortality. Ann Surg. 1968 Oct;168(4):629–640. doi: 10.1097/00000658-196810000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Leger L., Lenriot J. P., Lemaigre G. Five to twenty year followup after surgery for chronic pancreatitis in 148 patients. Ann Surg. 1974 Aug;180(2):185–191. doi: 10.1097/00000658-197408000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. MONGE J. J., JUDD E. S., GAGE R. P. RADICAL PANCREATODUODENECTOMY: A 22-YEAR EXPERIENCE WITH THE COMPLICATIONS, MORTALITY RATE, AND SURVIVAL RATE. Ann Surg. 1964 Oct;160:711–722. doi: 10.1097/00000658-196410000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. PORTER M. R. Carcinoma of the pancreatico-duodenal area; operability and choice of procedure. Ann Surg. 1958 Oct;148(4):711–724. doi: 10.1097/00000658-195810000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Proctor H. J., Mendes O. C., Thomas C. G., Jr, Herbst C. A. Surgery for chronic pancreatitis. Drainage versus resection. Ann Surg. 1979 May;189(5):664–671. doi: 10.1097/00000658-197905000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Ruilova L. A., Hershey C. D. Experience with 21 pancreaticoduodenectomies. Arch Surg. 1976 Jan;111(1):27–30. doi: 10.1001/archsurg.1976.01360190029004. [DOI] [PubMed] [Google Scholar]
  28. Sato T., Saito Y., Noto N., Suda Y. Evaluation of surgical treatment of chronic pancreatitis. Tohoku J Exp Med. 1970 Aug;101(4):351–362. doi: 10.1620/tjem.101.351. [DOI] [PubMed] [Google Scholar]
  29. Sato T., Saitoh Y., Noto N., Matsuno K. Appraisal of operative treatment for chronic pancreatitis. With special reference to side to side pancreaticojejunostomy. Am J Surg. 1975 Jun;129(6):621–628. doi: 10.1016/0002-9610(75)90333-5. [DOI] [PubMed] [Google Scholar]
  30. Stefanini P., Carboni M., Patrassi N., Benedetti-Valentini F J. Surgical treatment of chronic pancreatitis. Am J Surg. 1972 Jul;124(1):28–30. doi: 10.1016/0002-9610(72)90159-6. [DOI] [PubMed] [Google Scholar]
  31. Traverso L. W., Tompkins R. K., Urrea P. T., Longmire W. P., Jr Surgical treatment of chronic pancreatitis. Twenty-two years' experience. Ann Surg. 1979 Sep;190(3):312–319. doi: 10.1097/00000658-197909000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Tsuchiya R., Furukawa M., Furuse H., Sugihara Y., Oshibuchi H. Pancreatoduodenectomy: Our experiences and method of reconstruction. Jpn J Surg. 1971 Jun;1(2):167–172. doi: 10.1007/BF02468899. [DOI] [PubMed] [Google Scholar]
  33. Turner F. W. Symposium on pancreatitis: 4. Surgery in chronic pancreatitis. Can J Surg. 1978 Jan;21(1):63–67. [PubMed] [Google Scholar]
  34. Warren K. W., Choe D. S., Plaza J., Relihan M. Results of radical resection for periampullary cancer. Ann Surg. 1975 May;181(5):534–540. doi: 10.1097/00000658-197505000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Warren K. W., Choe D. S., Plaza J., Relihan M. Results of radical resection for periampullary cancer. Ann Surg. 1975 May;181(5):534–540. doi: 10.1097/00000658-197505000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Warren K. W., Mountain J. C. Comprehensive management of chronic relapsing pancreatitis. Surg Clin North Am. 1971 Jun;51(3):693–710. doi: 10.1016/s0039-6109(16)39446-4. [DOI] [PubMed] [Google Scholar]
  37. Whipple A. O., Parsons W. B., Mullins C. R. TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER. Ann Surg. 1935 Oct;102(4):763–779. doi: 10.1097/00000658-193510000-00023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Whipple A. O. Radical Surgery for Certain Cases of Pancreatic Fibrosis associated with Calcareous Deposits. Ann Surg. 1946 Dec;124(6):991–1006. [PMC free article] [PubMed] [Google Scholar]
  39. White T. T., Hart M. J. Pancreaticojejunostomy versus resection in the treatment of chronic pancreatitis. Am J Surg. 1979 Jul;138(1):129–134. doi: 10.1016/0002-9610(79)90252-6. [DOI] [PubMed] [Google Scholar]
  40. White T. T., Slavotinek A. H. Results of surgical treatment of chronic pancreatitis. Report of 142 cases. Ann Surg. 1979 Feb;189(2):217–224. doi: 10.1097/00000658-197902000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Yellin A. E., Rosoff L., Sr Pancreatoduodenectomy for combined pancreatoduodenal injuries. Arch Surg. 1975 Oct;110(10):1177–1183. doi: 10.1001/archsurg.1975.01360160015001. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES