Clinical analysis of central pancreatectomy in 19 cases
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Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China

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R657.5

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    Abstract:

    Background and Aims Pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) are considered as the standard procedures for pancreatic tumors. However, it needs to be noted that the endocrine and exocrine pancreatic insufficiency may occur after performing these tow procedures for benign or low-grade malignant tumors. The aim of this study was to investigate the clinical efficacy of central pancreatectomy (CP) for benign or low-grade malignant tumors in the neck and proximal body of the pancreas.Methods The clinical data of 19 patients who underwent CP from June 2009 to August 2020 in the First Affiliated Hospital of Nanchang University were retrospectively analyzed. Among the patients, there were solid pseudopapillary tumor in 8 cases, serous cystadenoma in 4 cases, neuroendocrine tumor in 4 cases, and pseudocyst, paraganglioma and inflammatory granuloma in one case each.Results Fifteen patients underwent open surgery and 4 patients had minimally invasive surgery. The reconstruction methods of the distal pancreatic remnant included duct-to-mucosa pancreaticojejunostomy in 15 cases and pancreaticogastrostomy in 4 cases. The mean operative time was (224.0±40.4) min, and the mean intraoperative blood loss was (173.2±50.9) mL. The incidence rates of overall complications and clinically relevant postoperative pancreatic fistula were 52.6% and 26.3%, respectively. The mean postoperative hospital stay was (11.8±6.5) d. No reoperation and surgery-related death occurred. The mean follow-up time was (59.3±39.0) months, and endocrine or exocrine pancreatic insufficiency occurred in none of them as well as no tumor recurrence was noted.Conclusion CP for the treatment of benign or low-grade malignant lesions in the neck or proximal body of the pancreas can maximally preserve the endocrine and exocrine pancreatic function, but it is associated with a relative high incidence of pancreatic fistula.

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YANG Zhengjiang, FU Xiaowei, SUN Gen, XIN Wanpeng, YI Siqing, JIANG Hai, LI Yong, XIAO Weidong. Clinical analysis of central pancreatectomy in 19 cases[J]. Chin J Gen Surg,2022,31(3):304-309.
DOI:10.7659/j. issn.1005-6947.2022.03.003

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History
  • Received:March 28,2021
  • Revised:October 09,2021
  • Adopted:
  • Online: April 02,2022
  • Published: