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The observation and analysis of efficacy of duodenum-preserving pancreatic head resection for patients with chronic pancreatitis

Objective: To investigate and analyze the efficacy of duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis (CP).

Methods: A retrospective analysis was performed regarding a total of 21 patients with CP combined with intractable abdominal pain, jaundice, or pancreatic duct stones who were admitted into Hepatobiliary Pancreatic Surgery Department of Henan Province People's Hospital from February 2010 to March 2016. All patients underwent DPPHR, which included 15 males and 6 females, aged 31-48 years, mean (39.5 ± 6.7) years. Patients’ 6-month postoperative fasting plasma glucose (FPB), oral glucose tolerance test (2 h-OGTr), weight, pain (VAS visual method), diarrhea symptoms, and quality of life assessment (GLQI Scale) were measured.

Results: There was no operative death in this group of patients. The major complication was postoperational pancreatic leakage, which was five cases with the incidence of 23.8% (5/21). Abdominal pain was relieved in a total of 18 patients and significantly reduce in three cases with occasional episodes of upper abdominal pain. Pain scores were decreased significantly (7.8 ± 3.6 and 58.1 ± 5.6, P<0.05). The 6-month postoperative FPB changes were not statistically significant ((5.3 ± 0.4) mmol/L and (5.4 ± 0.4) mmol/L, P> 0.05). The 2 h-OGTr changes were not statistically significant either ((8.0 ± 0.6) mmol/L and (7.9 ± 0.6) mmol/L, P> 0.05). No new diabetes case occurred during the 6-month follow-up. The body weight was increased with the average increase of (4.8 ± 0.7) kg ((58.8 ± 1.8) kg and (53.9 ± 2.0) kg, P<0.05)). In addition, the quality of life was also improved significantly (78.1 ± 7.3 and 61.0 ± 6.2, P<0.05).

Conclusion: DPPHR can relieve abdominal pain in patients with CP without compromising pancreatic functions. It also can help to improve the quality of life in patients with CP.

Author(s): Yan Shang, Chunlin GE