Duodenum-preserving pancreatic head resection in chronic pancreatitis : Limitations of the Heidelberg multicenter ChroPac study

Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
H G Beger, B Mayer

Abstract

The data published in Der Chirurg and The Lancet on the results of the multicenter ChroPac study comparing results of 115 patients in the duodenum-preserving pancreatic head resection (DPPHR) group with 111 patients in the pancreaticoduodenectomy (PD) group, recommend partial PD as the first line procedure for chronic pancreatitis (CP). This is based on the significantly higher frequency of rehospitalization assigned to CP in the DPPHR group and data derived from post hoc meta-analysis about higher frequency of reoperations in the DPPHR group. Based on the presented data of the intention-to-treat analysis it is difficult to support the authors' recommendation of PD as the first line procedure for CP. The critical points are substantial heterogeneity of the different surgical procedures in the DPPHR group (20%) and PD group (13.5%) and a heterogeneity with respect to the number of patients with very advanced CP in the DPPHR group but not in the PD group. The data on the new onset of diabetes and endocrine insufficiency after surgery are not the result of measuring the preoperative and postoperative status of glucose metabolism and degree of exocrine dysfunction but are based on patient records. The advantages and/or disadvantage...Continue Reading

References

Jun 22, 2000·International Journal of Pancreatology : Official Journal of the International Association of Pancreatology·G H SakorafasM G Sarr
May 7, 2002·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Helmut WitzigmannJohann Hauss
Dec 25, 2004·Diabetes Care·UNKNOWN American Diabetes Association
May 8, 2007·Journal of the American College of Surgeons·Thomas SchnelldorferDavid B Adams
Oct 17, 2012·Archives of Surgery·Zi YinJie Wang
Feb 20, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·H G Beger, B Poch
Feb 24, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Zaynab A R JawadLong R Jiao
Sep 14, 2017·Lancet·Melena D Bellin, Gregory J Beilman

❮ Previous
Next ❯

Citations

Mar 25, 2019·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Hans G BegerB Poch

❮ Previous
Next ❯

Related Concepts

Related Feeds

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.