Abstract:Objective
To explore the methods of surgical treatment of patients with tumors in the body and tail of pancreas.
Methods We analyzed the clinical data from 45 patients with tumors in the body and tail of pancreas who underwent surgical excision between 1984 and 2002 in our hospital. The 45 cases consisted of malignant tumors(n=33) and benign tumors(n=12). Operations performed included resection of the body and tail of pancreas(17 cases), combinedorgan excision (24 cases) and local tumor resection(4 cases).
Results Pathological classification:carcinoma (33 cases), islet cell tumors (8 cases), cystic adenoma(8 cases), epithelioid fibroma (1 case) and cystic teratoma (1 case). The average diametersize of excised tumor was determined as follows: carcinoma in the body or tail of pancreas was(8.0±2.6)cm, and that of islet cell tumors was(6.5±2.4)cm. There were no operative deaths, but operation resulted in the following complications: pancreatic fistula (2 cases), subdiaphragmatic abscess (2 cases), pancreatic pseudocyst (1 case ), upper gastrointestinal bleeding(1 case) and infection or poor healing of incisional wound (3 cases). All of the complications were cured with conservative therapy.
ConclusionsExcision of the body and tail of pancreas is an effective method for the treatment of patients with tumors in the distal half of pancreas.Before operation, it is necessary to be routinely prepared to perform combined organ excision. Regarding the surgical handling of pancreatic stump, we select the use of ligation of main pancreatic duct plus mattress suture, which we believe could effectively prevent pancreatic fistula.