The surgical procedure and clinical results of subtotal stomach preserving pancreaticoduodenectomy (SSPPD) in comparison with pylorus preserving pancreaticoduodenectomy (PPPD)

Background: Subtotal stomach preserving pancreaticoduodenectomy (SSPPD) is compared retrospectively with pylorus preserving pancreaticoduodenectomy (PPPD). Methods: During 2002-2005, 21 patients (13 female, 8 male) underwent SSPPD. The mean age was 64.3 (range 33-80). PPPD was performed for 12 patients after 1999. Days of hospital stay, operation time, operative blood loss, postoperative morbidity and mortality, days of nasogastric intubation, days until liquid diet, delayed gastric emptying, postoperative change of serum Albumin value, were compared between SSPPD and PPPD. Clinical characteristics (age, gender, benign, or malignant condition, presence of preoperative jaundice, preoperative value of serum Albumin) were analyzed in both procedures. Results: In comparison of clinical characteristics, all factors were similar between PPPD and SSPPD. There were also quite similar results in days of hospital stay, operation time, operative blood loss, postoperative morbidity and mortality. Days of nasogastric intubation, days until liquid diet in PPPD were significantly longer than those in SSPPD and the incidence of delayed gastric emptying in PPPD was significantly higher than that in SSPPD. Finally, PPPD and SSPPD postoperative change of serum Albumin value were statistically similar. Conclusions: We consider SSPPD as one of the most favorable procedures in patients who undergo pancreaticoduodenectomy.