ArticleSurgery open science2025
Association of pylorus preservation with outcomes of pancreaticoduodenectomy across the United States.
Article in Surgery open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pylorus-preserving pancreaticoduodenectomy (PPPD) was developed to improve postoperative gastrointestinal function while maintaining oncologic adequacy. However, conflicting evidence and concerns persist regarding increased delayed gastric emptying, warranting a national-level investigation. Methods: This retrospective cohort study analyzed 40,063 adult pancreaticoduodenectomy procedures from the ACS NSQIP database (2014-2023). Patients were stratified into pylorus-preserving and non-pylorus-preserving groups. Multivariable regression models evaluated independent associations between pylorus-preserving status and clinical outcomes including infectious complications, blood transfusions, delayed gastric emptying, and length of stay. Results: Of 40,063 pancreaticoduodenectomy procedures, 13,882 (34.6 %) were pylorus-preserving. PPPD was associated with lower rates of infectious complications (25.9 vs 27.5 %, Conclusion: Despite declining utilization over the study period, PPPD offers significant advantages in reducing infectious complications and blood transfusion requirements while shortening operative times and hospital stay. However, the trade-off of increased delayed gastric emptying requires careful consideration in surgical decision-making. These findings support individualized approach selection based on patient complexity and surgeon expertise to optimize perioperative outcomes.
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Registered trials
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