Retrospective Study
Copyright ©The Author(s) 2017.
World J Gastroenterol. Sep 21, 2017; 23(35): 6457-6466
Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6457
Table 1 Preoperative characteristics and final pathologic features of 23 patients in the duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy groups n (%)
Patient characteristicsDVPPST(n = 10)TP (n = 13)P vaule
Age (range, yr)49 ± 16.9 (24-71)56 ± 10.1 (40-70)0.256
Gender (%)0.680
Male4 (40)7 (54)
Female6 (60)6 (46)
Major comorbidity
CAD011.000
COPD121.000
DM231.000
Hypertension331.000
Preoperative symptoms
Incidental02 (15)0.486
Symptomatic (%)10 (100)11 (85)
Abdominal pain4 (40)6 (55)1.000
Pancreatitis140.339
Weight loss140.339
Gastrointestinal symptoms430.65
ASA score1.000
I/II710
III33
Pathology (%)0.411
IPMN6 (60)11 (85)
Low-grade moderate-grade dysplasia210.515
High-grade dysplasia340.644
Invasive carcinoma1 (16.7)5 (45.5)0.333
Neuroendocrine tumor21
G 2211.000
SPT21
Total invasive malignancy1 (10)5 (38.5)0.179
CAD: Coronary artery disease; COPD: Chronic obstructive pulmonary disease; DM: Diabetes mellitus; IPMN: Intraductal papillary mucinous neoplasm; SPT: Pseudo-papillary tumor; DVPPSP: Duodenum and ventral pancreas preserving subtotal pancreatectomy.
Table 2 Intraoperative and postoperative outcomes of 23 patients after duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy
Operative characteristicsDVPPSP(n = 10)TP (n = 13)P vaule
Intraoperative transfusion (U)0.20 ± 0.63 (0-2)0.54 ± 1.05 (0-3)0.379
Operative time (min)232 ± 19.6 (215-255)335 ± 32.3 (280-400)< 0.001
Postoperative characteristics
DGE011.000
Biliary fistula011.000
Pancreatic fistula (B and C)00—
Overall morbidity250.405
Major morbidity (≥ grade 3)121
Reoperation00—
Readmission (30 d)00—
LOS9.7 ± 3.8 (7-20)11.7 ± 5.2 (8-26)0.318
Mortality00—
Recurrence1(%)2 (20%)5 (38.5%)0.405
IPMN2/65/111.000
1The recurrences of 2 patients in the DVPPSP group and 5 patients in the TP group occurred after surgery for IPMN. DGE: Delayed gastric emptying; LOS: Length of postoperative stay; DVPPSP: Duodenum and ventral pancreas preserving subtotal pancreatectomy.
Table 3 Postoperative condition of supplementary therapy of 23 patients after duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy
ParametersDPPSP(n = 10)TP (n = 13)P vaule
Enzymes replacement (cps/d)0.9 ± 2.09.2 ± 2.2< 0.001
Total insulin dose (U/d)6.4 ± 14.029.7 ± 9.3< 0.001
Diarrhea or steatorrhea240.660
Hyperglycemia050.046
TP: Total pancreatectomy; DVPPSP: Duodenum and ventral pancreas preserving subtotal pancreatectomy.
Table 4 Postoperative condition of diabetes of 10 patients in the duodenum and ventral pancreas preserving subtotal pancreatectomy group
ParametersDPPSP (n = 10)
New-onset diabetes0 / 7
Worsen diabetes11/3
Diet to oral medication—
Diet to insulin—
Oral medication to insulin11/3
1There was 3 out of 10 patients in DVPPSP group who had diabetes before surgery and were treated by oral medicine. DVPPSP: Duodenum and ventral pancreas preserving subtotal pancreatectomy.
Table 5 Quality of lives after duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy
ParametersDVPPSP(n = 8)TP (n = 8)P vaule
Functional scale
Physical95.0 ± 9.3 (80-100)97.5 ± 7.1 (80-100)0.554
Working ability100100—
Cognitive100100—
Emotional98.4 ± 2.9 (93.8-100)92.2 ± 8.0 (75-100)0.057
Social95.8 ± 7.7 (83.3-100)85.4 ± 10.7 (66.7-100)0.042
Global QoL96.9 ± 6.2 (83.3-100)88.5 ± 8.9 (75-100)0.047
Symptom scale
Fatigue4.2 ± 8.3 (0-22.2)11.1 ± 11.7 (0-33.3)0.196
Nausea and vomiting06.3 ± 12.4 (0-33.3)0.197
Pain00—
Appetite loss020.8 ± 24.8 (0-66.7)0.049
Dyspnea00—
Sleep disturbance4.2 ± 11.8 (0-33.3)12.5 ± 17.2 (0-33.3)0.281
Constipation04.2 ± 11.8 (0-33.3)0.351
Diarrhea4.2 ± 11.8 (0-33.3)12.5 ± 24.8 (0-66.7)0.405
Financial strain08.3 ± 15.4 (0-33.3)0.170
TP: Total pancreatectomy; QoL: Quality of life; DVPPSP: Duodenum and ventral pancreas preserving subtotal pancreatectomy.