Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5794
Peer-review started: November 23, 2014
First decision: January 22, 2015
Revised: February 25, 2015
Accepted: April 17, 2015
Article in press: April 17, 2015
Published online: May 21, 2015
Processing time: 179 Days and 6.1 Hours
Pancreaticoduodenectomy (PD) will result in removal of important multiorgans in upper intestinal tract and subsequently secondary physiologic change. In the past, surgeons just focused on the safety of surgical procedure; however, PD is regarded as safe and widely applied to treatment of periampullary lesions. Practical issues after PD, such as, effect of duodenectomy, metabolic surgery-like effect, alignment effect of gastrointestinal continuity, and non-alcoholic fatty liver disease were summarized and discussed.
Core tip: In the past, pancreaticoduodenectomy (PD) should be avoided because of its extremely high morbidity and mortality. With the advance of surgical techniques and perioperative management, PD has been regarded as good choice for the treatment of periampullary pathologic conditions. In this moment, turning our interest to potential physiological change following PD may be necessary, because PD always results in removal of important internal organs in upper gastrointestinal tract and altering normal path of gastrointestinal flow. Well awareness of these “internal” changes will be helpful for proper management of the patients with PD.