Most Total Pancreatectomies for Ductal Adenocarcinoma Can Be Replaced by Whipple Over the Splenic Artery: A Before and After Study

Study Overview
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Brief Summary
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Recently, more and more total pancreatectomy (TP) has been performed for pancreatic ductal cell adenocarcinoma (PDCA) which abuts or involves both gastroduodenal and splenic arteries. Warshaw's procedure (spleen-preserving distal pancreatectomy with excision of splenic vessels) has been safely performed for years. Likewise, both pancreatic tail and spleen can be preserved after excision of splenic vessels for leftward extension of pancreatic parenchyma transaction line during Whipple (WOTSA). In that case, TP can be replaced by WOTSA. This uncontrolled before and after study assesses the safety and efficacy of a new technique Whipple over the splenic artery (WOTSA) as a treatment for PDAC which traditionally requires total pancreatectomy (TP).

Detailed Description
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Recently, more and more total pancreatectomy (TP) has been performed for pancreatic ductal cell adenocarcinoma (PDCA) which abuts or involves both gastroduodenal and splenic arteries. Warshaw's procedure (spleen-preserving distal pancreatectomy with excision of splenic vessels) has been safely performed for years. Likewise, both pancreatic tail and spleen can be preserved after excision of splenic vessels for leftward extension of pancreatic parenchyma transaction line during Whipple (WOTSA). In that case, TP can be replaced by WOTSA. This uncontrolled before and after study assesses the safety and efficacy of a new technique Whipple over the splenic artery (WOTSA) as a treatment for PDAC which traditionally requires total pancreatectomy (TP). Methods: The study group comprised 40 consecutive patients who underwent WOTSA for PDAC. Their clinicopathological characteristics and survival were compared with those of a historical control group comprising 30 consecutive patients who underwent TP between.

Official Title
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Most Total Pancreatectomies for Ductal Adenocarcinoma Can Be Replaced by Whipple Over the Splenic Artery: A Before and After Study

Conditions
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Ductal Adenocarcinoma of the Pancreas

Intervention / Treatment
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* Procedure: Whipple over the splenic artery
* Procedure: Total pancreatectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pancreatic ductal cell adenocarcinoma (PDCA) patients Exclusion Criteria: Patient undergoing palliative pancreatectomy, other malignancies with distant metastases Vulnerable groups

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study<br>Patients who underwent Whipple over the splenic artery (WOTSA) as a treatment for PDAC | Procedure: Whipple over the splenic artery<br>* Treatment for pancreatic ductal cell adenocarcinoma<br>|
| Control<br>Patients who underwent total pancreatectomy (TP) as a treatment for PDAC | Procedure: Total pancreatectomy<br>* Treatment for pancreatic ductal cell adenocarcinoma<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinicopathological characteristics | Measurement of the remnant pancreatic volume | before | 
| Clinicopathological characteristics | Measurement of the remnant pancreatic volume | 1 week after the operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative chemotherapy and follow-up | Measurement of the remnant pancreatic volume and physiological parameters | 1 month after the operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ductal Adenocarcinoma, Pancreatectomies, Whipple