Is pylorus resecting pancreaticoduodenectomy a better surgical alternative than pylorus preserving pancreaticoduodenectomy regarding delayed gastric emptying?

Pylorus preserving pancreaticoduodenectomy (PPPD) has been popularized as the surgical approach for patients with periampullary lesions by Traverso and Longmire since 1978 (1). It was first hypothesized to reduce the occurrence of dumping, diarrhea, bile reflux gastritis and improve overall nutritional status compared with classic pancreaticoduodenectomy, also known as classic Whipple (CW).