[Cephalic duodenopancreatectomy with pylorus preservation: for which patients?].

From 1984 to the end of 1993, we performed 51 duodenopancreatectomies with pylorus preservation (27 for chronic pancreatitis and 24 for tumours). We have a complete follow up for 96% of our patients with a mean range of 76 months in the first group and 33 months in the second. There was no per- or postoperative mortality and 15% immediate postoperative morbidity. We observed 5 cases (10%) of anastomotic ulceration. New surgical technics enabled us to avoid this major complication for our last 31 patients. The short and long term benefits of pylorus-preserving duodenopancreatectomy on patients' wellbeing, nutritional status and weight gain were confirmed in 22 patients (82%) with pancreatitis. The mean survival time in patients with tumors (periampullary and head of pancreas adenocarcinoma) is similar to that with the classical Whipple procedure.