• Quan Shen, Huan-zhou Xue, Qing-feng Jiang, and Ya-dong Wang.
• Department of General Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China. shenquangz@sina.com
• Zhonghua Yi Xue Za Zhi. 2010 Nov 30; 90 (44): 3127-30.

ObjectiveTo evaluate the therapeutic efficacy of duodenum-preserving pancreatic head resection (DPPHR) for severe chronic pancreatitis (CP).MethodsFrom February 2004 to March 2010, duodenum-preserving resection of pancreatic head was performed in 21 patients with severe CP. A "modified-DPPHR" was carried out in 14 patients of them and a "Frey's DPPHR" in the other 7 patients. The values of fasting plasma blood (FPB), oral glucose tolerance test (OGTT), body weight (BW), visual analogue pain intensity scale (VAS score) and the quality of life indices were evaluated before and 6(th) month after surgery.ResultsThere was no hospital mortality. The complications from adjacent organs were resolved definitively. Pancreatic fistula was the major and the most frequent morbidity occurring in 23.8% of the patients. After operation 85.7% of the patients were completely pain-free and 14.3% had continuing abdominal pain. The VAS score decreased more after surgery comparing with before and there was a significant difference (81.1 ± 5.6 vs 7.8 ± 3.6, P < 0.05). The value of FPB in post-operative patients was similar to that in pre-operative ones and there was no significant difference [(5.3 ± 0.4) mmol/L vs (5.4 ± 0.4) mmol/L, P > 0.05]. The value of 2 h-OGGT in post-operative patients was also similar to that in pre-operative ones and it did not differ significantly [(8.0 ± 0.6) mmol/L vs (7.9 ± 0.6) mmol/L, P > 0.05]. After operation 77.8% of patients gained more than 5% of their pre-operative body weight with a mean increment of (4.8 ± 0.7) kg (58.8 ± 1.8 vs 53.9 ± 2.0, P < 0.05). A significant rise of the overall quality of life index was observed after surgery (78.1 ± 7.3 vs 61.0 ± 6.2, P < 0.05).ConclusionDPPHR is both safe and effective with regard to pain relief, a definitive control of complications affecting adjacent organs and an improvement of overall quality of life. It leads to no further deterioration of pancreatic functions.

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