Abstracts
1999 Digestive Disease Week

# 2137 QUALITY OF LIFE: WHIPPLE PROCEDURE VERSUS PYLORUS-PRESERVING PANCREATODUODENECTOMY FOR PERIAMPULLARY CANCER
C Bloechle, Univ Hosp of Eppendorf, Hamburg Germany; C F Eisenberger, D C Broering, Univ Hosp Eppendorf, Hamburg Germany; Wolfram T Knoefel, J R Izbicki, Univ Hosp Hamburg-Eppendorf, Hamburg Germany

Background: For years the Whipple procedure (PD) has been the surgical standard treatment of periampullary neoplasms. Nowadays pylorus-preserving pancreaticoduodenectomy (PPPD) according to Longmire-Traverso has received increasing attention as a more physiological, organ-preserving alternative to the standard pancreatiicoduodenectomy (PD). In the PD extensive resection may provide longer survival, whereas PPPD may provide better quality of life and comparable survival. Survival and quality of life are the crucial end-points for the patients. Objective: To evaluate the quality of life after PD vs. PPPD for periampullary cancer this prospective randomized study was devised. Methods: 50 patients were randomized either to PD or PPPD. End-points of the study were quality of life, morbidity, mortality, endocrine (insulin, C-peptide, HbA1C) and exocrine (pancreolauryl-test, chymotrypsin) function, and survival. Results: Hospital mortality was zero. Morbidity was 33% in the PD group (wound infection, delayed gastric emptying, fistula, leak, pancreatitis) and 48% in the PPPD group (delayed gastric emptying, fistula, leak, would infection). There was no significant difference in endocrine and exocrine pancreatic function between the two groups. Quality of life symptom scales revealed comparable values, while better appetite and faster weight gain was observed in the PPPD group. Globale quality of life showed a slight, but not significant advantage for the PPPD compared to the PD during median follow-up of 18 months (range 6-36). Disease-free survival during follow-up was equal in both groups. Conclusions: PD and PPPD are equally safe and effective, especially with regard to quality of life.

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