Organ preserving pancreatectomy for pancreatic benign or low-grade malignant tumor: a report of 66 cases in a single institution
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R735.9

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    Abstract:

    Objective: To investigate the clinical value of organ preserving pancreatectomy in treatment of benign or low-grade malignant pancreatic tumors. Methods: The clinical data of 66 patients with pancreatic benign or low-grade malignant tumor who underwent organ preserving pancreatectomy from January 2009 to December 2016 in the Department of General Surgery of the First Affiliated Hospital, Nanchang University were retrospectively analyzed. Of the patients, the lesion included insulinoma in 34 cases, solid pseudopapillary tumor in 6 cases, serous cystadenoma in 9 cases, intraductal papillary mucinous tumor in 4 cases, and nonfunctional neuroendocrine tumor, paraganglioma and mucinous cystadenoma in one case each; 34 cases underwent tumor enucleation, 10 cases underwent middle segmental pancreatectomy, 13 cases underwent spleen-preserving distal pancreatectomy, 6 cases underwent pylorus-preserving pancreaticoduodenectomy and 3 cases underwent duodenum-preserving pancreatic head resection. Results: The mean operative time was (163.6±77.4) min, intraoperative blood loss was (234.4±242.7) mL, and length of postoperative hospital stay was (11.3±8.1) d. The incidence of overall abdominal complications, biochemical pancreatic leak, grade B/C pancreatic fistula, intra-abdominal infection, delayed gastric emptying and intra-abdominal bleeding were 36.4%, 15.2%, 10.6%, 6.1%, 3.0% and 1.5%, respectively. No reoperation was required and no death occurred in any of the patients. After the mean follow-up period of (47.2±25.6) months, the incidence of new-onset diabetes mellitus and requirement of pancreatic enzyme replacement therapy was 3.1% (the34 cases with insulinoma were excluded) and 1.5% respectively, and no recurrence or metastasis was observed. Conclusion: Organ preserving pancreatectomy can maximally preserve the pancreatic parenchyma and adjacent organs, avoid the excessive loss of pancreatic endocrine and exocrine functions and preserve the function of the spleen. It should be considered as the first option for treatment of benign or low-grade malignant pancreatic tumor.

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XIAO Weidong, LIN Shengrong, WU Antao, CAI Jun, ZHENG Donghui, YU Yonghuan. Organ preserving pancreatectomy for pancreatic benign or low-grade malignant tumor: a report of 66 cases in a single institution[J]. Chin J Gen Surg,2018,27(3):284-288.
DOI:10.3978/j. issn.1005-6947.2018.03.003

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History
  • Received:September 27,2017
  • Revised:February 13,2018
  • Adopted:
  • Online: March 15,2018
  • Published: