Pylorus Preserving Kausch-Whipple Resection: The Successor of the Classical Kausch-Whipple in Chronic Pancreatitis

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J. SLAVIN, MS, FRCS (GEN), P. GHANEH, FRCS, R. SUTTON, DPHIL, FRCS (GEN), J. P. NEOPTOLEMOS, MA, MD, FRCS

Ann. Ital. Chir., LXXI, 1, 2000

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Chronic pancreatitis can be a debilitating disease. Resection for complicated disease and in those patients with intractable pain is a major component of therapy. There are potentially important physiological advantages with the pylorus preserving Kausch-Whipple (P-KW)compared to the standard Kausch-Whipple (KW) resection but further prospective studies are required to show this unequivocally. The Beger’s operation also represents a significant theoretical advance. Indeed it permits resection in a proportion in whom a PPKW or KW would not be possible technically because of severe fibrosis around the intra-pancreatic portal venous system. Although we have adopted the Beger’s operation on our unit, large comparative studies are required against the KW and PP-KW procedures to properly establish its value. The hidden malignancy is an important issue, which undermines the routine use of the Beger’s operation.