Pyloric preservation with the Whipple procedure.

The pylorus-preserving pancreatoduodenectomy simplifies resection, allows a satisfactory postoperative weight gain, prevents postgastrectomy symptoms, is followed by a low rate of jejunal ulceration, and can be performed with an extremely low postoperative mortality rate, providing that the pancreatic and biliary anastomoses are constructed so that no leakage occurs. Preliminary data indicate a satisfactory survival rate when this procedure is used for periampullary cancer, and reasonable relief of pain is achieved when the procedure is used in chronic pancreatitis.