Evidence map›Paper›PMID 15492552›Full record

Trial reportAnnals of surgery2004

Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure: a prospective, randomized, multicenter analysis of 170 patients with pancreatic and periampullary tumors.

Khe T C Tran, Hans G Smeenk, Casper H J van Eijck, Geert Kazemier, Wim C Hop, Jan Willem G Greve, Onno T Terpstra, Jan A Zijlstra, Piet Klinkert, Hans Jeekel

Registry-linked trialOpen access · greenAbstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgery, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01460550 (Comparison Between Antecolic and Retrocolic Gastrointestinal Reconstruction in Delayed Gastric Emptying After Pancreaticoduodenectomy), which is not on this map. Cited by 143 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
143citing papers in PubMed, 15 pooled it
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01460550 phase3unknown statusnot on this mapstarted 2011, after this paper: background citation

Comparison Between Antecolic and Retrocolic Gastrointestinal Reconstruction in Delayed Gastric Emptying After Pancreaticoduodenectomy: A Prospective Randomized Controlled Multicenter Trial

TypeinterventionalSponsorKobe UniversityRan2011 to 2017Enrolled240ConditionsPostprocedural Delayed Gastric EmptyingArmsRetrocolic gastro- or duodeno- jejunostomy in hte pancreaticoduodenectomy, Antecolic gastro- or duodeno- jejunostomy in the pancreaticoduodenectomy
3 · Its place in the literature

Who cites it

143 citing papers in PubMed, 15 syntheses or guidelines pooled it, 415 citations in OpenAlex.

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  5. Is there comparable morbidity in pylorus-preserving and pylorus-resecting pancreaticoduodenectomy? A meta-analysis.Journal of Huazhong University of Science and Technology. Medical sciences = Hua zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. Yixue Yingdewen ban · 2015
    Pooled it
  6. Delayed Gastric Emptying After Pancreaticoduodenectomy: Is Subtotal Stomach Preserving Better or Pylorus Preserving?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015
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  12. SEOM clinical guidelines for the treatment of pancreatic cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2011
    Guideline
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83 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Khe T C TranDepartment of General Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Hans G Smeenk
Casper H J van Eijck
Geert Kazemier
Wim C Hop
Jan Willem G Greve
Onno T Terpstra
Jan A Zijlstra
Piet Klinkert
Hans Jeekel
Erasmus MC · NLLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveA prospective randomized multicenter study was performed to assess whether the results of pylorus-preserving pancreaticoduodenectomy (PPPD) equal those of the standard Whipple (SW) operation, especially with respect to duration of surgery, blood loss, hospital stay, delayed gastric emptying (DGE), and survival. SUMMARY BACKGROUND DATA: PPPD has been associated with a higher incidence of delayed gastric emptying, resulting in a prolonged period of postoperative nasogastric suctioning. Another criticism of the pylorus-preserving pancreaticoduodenectomy for patients with a malignancy is the radicalness of the resection. On the other hand, PPPD might be associated with a shorter operation time and less blood loss.

methodsA prospective randomized multicenter study was performed in a nonselected series of 170 consecutive patients. All patients with suspicion of pancreatic or periampullary tumor were included and randomized for a SW or a PPPD resection. Data concerning patients' demographics, intraoperative and histologic findings, as well as postoperative mortality, morbidity, and follow-up up to 115 months after discharge, were analyzed.

resultsThere were no significant differences noted in age, sex distribution, tumor localization, and staging. There were no differences in median blood loss and duration of operation between the 2 techniques. DGE was observed equally in the 2 groups. There was only a marginal difference in postoperative weight loss in favor of the standard Whipple procedure. Overall operative mortality was 5.3%. Tumor positive resection margins were found for 12 patients of the SW group and 19 patients of the PPPD group (P < 0.23). Long-term follow-up showed no significant statistical differences in survival between the 2 groups (P < 0.90).

conclusionsThe SW and PPPD operations were associated with comparable operation time, blood loss, hospital stay, mortality, morbidity, and incidence of DGE. The overall long-term and disease-free survival was comparable in both groups. Both surgical procedures are equally effective for the treatment of pancreatic and periampullary carcinoma.

Indexed as

Ampulla of VaterAdenocarcinomaAdultAgedBlood Loss, SurgicalCommon Bile Duct NeoplasmsDisease-Free SurvivalFemaleGastric EmptyingHumansLength of StayMaleMiddle AgedPancreatic NeoplasmsPancreaticoduodenectomyPostoperative Complications

Identifiers

PMID15492552
PMCPMC1356476
OpenAlexW2125561272

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.