Is there a place for central pancreatectomy in pancreatic surgery?

Iacono, Calogero; Bortolasi, Luca; Serio, Giovanni

doi:10.1016/s1091-255x(98)80050-4

Cited by 89 publications

(125 citation statements)

References 30 publications

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“…The incidence of pancreatic fistula is reported to be 14 to 30% as compared to 5 to 15% in distal pancreatectomy. 6 Most series have no mortality but high morbidity following middle pancreatectomy, the mortality in our series was due to pancreatic fistula from the proximal stump where the stapler was used. The incidence of pancreatic fistula is reported to be high with the stapler closure.…”

Section: Case Reportmentioning

confidence: 62%

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Middle pancreatectomy for selected pancreatic neck tumours

Lakhey

Ghimire

Khakurel

2010

Journal of Institute of Medicine

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Middle pancreatectomy has been indicated for small benign lesions located in the neck or body of the pancreas. The proponents of middle pancreatectomy argue that it preserves pancreatic exocrine and endocrine function thus avoiding pancreatic exocrine insufficiency and diabetes, and preserves spleen thereby avoiding life-threatening complication of post splenectomy sepsis. However, others express concern regarding the increased risk of pancreatic fistula and oncological adequacy. Here, we report two cases with low grade cystic neoplasm involving the neck of the pancreas that underwent middle pancreatectomy with variable outcome.

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Section: Case Reportmentioning

confidence: 62%

“…6 Both of our patients fulfilled the criteria and were subjected to middle pancreatectomy. There have been concern regarding the oncological adequacy of this surgery and frozen section is said to be mandatory as sometimes it is difficult to distinguish benign lesions from malignant lesions preoperatively.…”

Section: Case Reportmentioning

confidence: 97%

Middle pancreatectomy for selected pancreatic neck tumours

Lakhey

Ghimire

Khakurel

2010

Journal of Institute of Medicine

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“…CECT helped in localizing and charactersing the lesion (suggesting cystic neoplasm, chronic pancreatitis -focal type or hypodense malignant lesion) and also detailed about the rest of the pancreas. CP was performed in patients having 2-5 cm lesion in the neck and proximal body of pancreas where the remnant pancreas was more than 5 cm distally and suspicion of malignancy was not there [3].…”

Section: Discussionmentioning

confidence: 99%

“…It may result in endocrine, exocrine insuffi ciency and splenectomy may result in infective complications. CP for mid pancreatic lesion overcomes above disadvantages [3][4]. We performed CP on four patients for varied indications, between Jan. 2005 and June 2007.…”

Section: Introductionmentioning

confidence: 99%

Central pancreatectomy for neoplasm of mid pancreas — a report of four cases

et al. 2008

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Central pancreatectomy (CP) originally done for pancreatic trauma and focal pancreatitis is recently being performed for benign and low grade malignant neoplasm of mid pancreas. It offers the advantage of conserving pancreatic tissue and preserving gastroduodenal-biliary anatomy, important for maintenance of endocrine and exocrine pancreatic function. We reviewed our database between Jan. 2005 and June 2007. Four patients (2 males and 2 females) in the age range of 12 to 55 years underwent CP for a mass in the mid pancreas. Two were known diabetic. Histology reported solid variant of serous cystadenoma (1), solid pseudopapillary tumor (1), focal pancreatitis (1) and ductal adenocarcinoma (1). Postoperatively one patient had transient pancreatic fi stula which was managed conservatively. There was no mortality. On follow-up (7 to 43 months) none of the patients required enzyme supplements and diabetes did not worsen. Patient with ductal adenocarcinoma progressed within 7 months. CP may be a viable option for mid pancreatic lesions of benign or low grade malignant potential.Keywords Central Pancreatectomy . . Endocrine and exocrine pancreatic function . . Benign mid pancreatic lesion.

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“…In these cases, standard or extended pancreatectomies performed for benign or borderline cases, can result in the loss of a great amount of glandular tissue, significantly increasing the risk of diabetes, impaired exocrine function and splenic loss [1][2][3][4][5][6] . Enucleation would be an adequate alternative for small, benign and low-grade malignant tumours, such as endocrine and cystic neoplasms of the pancreas.…”

Section: Introductionmentioning

confidence: 99%

Middle Segment Pancreatectomy: A Useful Tool in the Management of Pancreatic Neoplasms

Bassi

2007

Journal of Gastrointestinal Surgery

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Small, benign or low grade malignant tumours located in the neck of the pancreas are usually treated with enucleation. However if enucleation is too risky because of possible damage to the main pancreatic duct, standard pancreatic resections are performed. Such operations can lead to impaired long term exocrine-endocrine function. Middle segment pancreatectomy consists of a limited resection of the midportion of the pancreas and can be performed in selected patients affected by tumours of the pancreatic neck. Middle segment pancreatectomy is a safe and feasible procedure for treating tumours of the pancreatic neck; in experienced hands it is associated with no mortality but with high morbidity; the rate of "clinical" pancreatic fistula is about 20%. Moreover, it allows the surgeon to preserve pancreatic parenchyma and consequently long term endocrine and exocrine pancreatic function.

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Is there a place for central pancreatectomy in pancreatic surgery?

Cited by 89 publications

References 30 publications

Middle pancreatectomy for selected pancreatic neck tumours

Middle pancreatectomy for selected pancreatic neck tumours

Central pancreatectomy for neoplasm of mid pancreas — a report of four cases

Middle Segment Pancreatectomy: A Useful Tool in the Management of Pancreatic Neoplasms

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