Objective
A prospective, randomized study was performed to evaluate two variations of the duodenum-preserving
pancreatic head resection (DPPHR), either with (Beger procedure) or without (Berne
modification) the division of the pancreas anterior to the portal vein, in patients
with chronic pancreatitis.
Methods
Randomized, controlled, patient-blinded trial of patients with inflammatory pancreatic
head tumors. The primary endpoint was the duration of surgery. Other a priori-ordered
endpoints were length of ICU stay, postoperative complication, length of hospital
stay, and quality of life after 24 months.
Results
Sixty-five patients were randomized to the Berne or Beger procedures. The Berne modification
could be performed faster (46 minutes difference, P < .05). The median length of stay on the ICU was one day in both groups (P = .97) but the median hospital stay was shorter in the Berne group (11 (8–39) versus
15 (8–47); P = .015). The quality of life two years after surgery did not differ significantly
between the two groups (EORTC-QLQ-C30, Beger 65.6% vs. Berne 71.3%, P = .371). Three patients who had received the Berne procedure were reoperated on during
the follow-up period due to ongoing pancreatitis and bile duct obstruction (P = .22).
Conclusion
The Berne technique is technically simpler compared with the original Beger procedure,
reflected in its significantly shorter operation times and hospital stays. The quality
of life is similar after both procedures. The Berne modification of DPPHR adds to
our panel of surgical procedures that can be applied with effective early and late
outcomes.
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Article info
Publication history
Published online: February 28, 2008
Accepted:
December 7,
2007
Footnotes
J.K. and C.M.S. contributed equally to the preparation of the manuscript
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
