BACKGROUND Outcomes of proximal parenchymal pancreatectomy (PPP) as compared to pancreatoduodenectomy (PD) have not been reported. The aim of this study was to describe the short- and long-term outcomes of patients with low-grade pancreatic head lesions who underwent PPP or PD. METHODS Patients who underwent PPP or PD for low-grade lesions between 2009 and 2017 were included. Operative factors including postoperative complications and nutritional indicators during the first-year postoperatively were compared. RESULTS A total of 13 and 14 patients underwent PPP and PD respectively. The PPP group demonstrated significantly less intraoperative blood loss and shorter postoperative hospital stay than the PD group. No significant differences were noted in the incidence of postoperative complications between the two groups. Nutritional indices were significantly better in the PPP group at 3 months post-surgery, but these nutritional indices were not significantly different at 6 months and 1-year. None of 12 patients who underwent PPP and did not require biliary resection developed postoperative cholangitis. None of the 12 PPP patients without preoperative diabetes developed impaired glucose tolerance after surgery. DISCUSSION The complication rate of PPP is equivalent to that of PD. PPP demonstrated better short-term nutritional status than PD. Moreover, preservation of the total duodenum and bile duct may reduce the risk of developing postoperative diabetes and cholangitis.

中文翻译：

---

近端实质性胰腺切除术对胰头低度恶性病变的术后营养益处。

背景技术与胰十二指肠切除术（PD）相比，近端实质性胰腺切除术（PPP）的结果尚未见报道。这项研究的目的是描述接受PPP或PD治疗的低度胰头病变患者的短期和长期预后。方法纳入2009年至2017年间因低度病变而接受PPP或PD治疗的患者。比较术后第一年的手术因素，包括术后并发症和营养指标。结果分别有13和14例患者接受了PPP和PD治疗。与PD组相比，PPP组的术中出血量明显减少，术后住院时间明显缩短。两组术后并发症的发生率无显着差异。术后3个月，PPP组的营养指数明显更好，但在6个月和1年时，这些营养指数没有显着差异。接受PPP且不需进行胆道切除术的12例患者中无一发生术后胆管炎。在没有术前糖尿病的12位PPP患者中，手术后均未出现糖耐量降低的情况。讨论PPP的并发症发生率与PD相当。PPP的短期营养状况优于PD。此外，保留十二指肠和胆总管可以减少发生术后糖尿病和胆管炎的风险。接受PPP且不需进行胆道切除术的12例患者中无一发生术后胆管炎。在没有术前糖尿病的12位PPP患者中，手术后均未出现糖耐量降低的情况。讨论PPP的并发症发生率与PD相同。PPP的短期营养状况优于PD。此外，保留十二指肠和胆总管可以减少发生术后糖尿病和胆管炎的风险。接受PPP且不需进行胆道切除术的12例患者中无一发生术后胆管炎。在没有术前糖尿病的12位PPP患者中，手术后均未出现糖耐量降低的情况。讨论PPP的并发症发生率与PD相同。PPP的短期营养状况优于PD。此外，保留十二指肠和胆总管可以减少发生术后糖尿病和胆管炎的风险。