Middle segmental pancreatectomy: A safe and organ-preserving option for benign and low-grade malignant lesions

Du, Zhifeng; Chen, Shi; Han, Baosan; Shen, Baiyong; Liu, Yingbing; Peng, Chenghong

doi:10.3748/wjg.v19.i9.1458

Cited by 37 publications

(41 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sample sizes in individual studies ranged from 20 to 4775 patients, with a total of 9970 patients included for analysis. Table summarizes the study characteristics and key results for the included studies . These studies included 5636 patients undergoing pancreaticoduodenectomy, 3922 patients with distal pancreatectomy and 315 undergoing central pancreatectomy.…”

Section: Resultsmentioning

confidence: 99%

“…Forest plot of studies indicating incidence of new‐onset DM after each type of resection. A, Pancreaticoduodenectomy . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

“…Incidence 9%‐24% (pooled estimate 16%; 95% CI: 14%‐17%), Q = 18.20; P = .31, I 2 = 12.10%. B, Distal pancreatectomy performed for resection of neoplasm . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

“…Incidence 3%‐40% (pooled estimate 21%; 95% CI: 16%‐25%), Q = 124.97; P = <.01, I 2 = 85.60%. C, Central pancreatectomy . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Nahm

Jamieson

et al. 2020

Clinical Endocrinology

View full text Add to dashboard Cite

Objectives: Type 3c diabetes mellitus (T3cDM) occurring post pancreatectomy can be challenging to treat due to the frequent combination of decreased circulating levels of insulin and glucagon and concurrent exocrine insufficiency. Relatively, little is known regarding the risk factors for development of T3cDM post pancreatectomy. Our aim was to review the literature and assess what is known of the risk factors for the development of new-onset DM following partial pancreatic resection and where possible determines the incidence, time of onset and the management approach to hyperglycaemia in this context. Design: Medline and Embase databases were reviewed using specific keyword criteria. Original manuscripts published in 1990 or later included. Articles with study population <20, lacking information on new-onset DM, follow-up duration or specifically targeting rare procedures/pathology were excluded. The Newcastle Ottawa Quality Assessment form was applied. Results reported according to PRISMA guidelines. Pooled effect size calculated using random effects model. Patients: Thirty six articles were identified that described a total of 5636 patients undergoing pancreaticoduodenectomy, 3922 patients having distal pancreatectomy and 315 with central pancreatectomy.Results: The incidence of new-onset DM was significantly different between different types of resection from 9% to 24% after pancreaticoduodenectomy (pooled estimate 16%; 95% CI: 14%-17%), 3%-40% after distal pancreatectomy (pooled estimate 21%; 95% CI: 16%-25%) and 0%-14% after central pancreatectomy (pooled estimate 6%; 95% CI: 3%-9%). Surgical site, higher preoperative HbA1c, fasting plasma glucose and lower remnant pancreatic volume had strongest associations with new-onset DM.Conclusions: This systematic review supports that risk of development of T3cDM is associated with type of pancreatic resection, lower remnant pancreatic volume and higher preoperative HbA1c. K E Y W O R D Sdiabetes mellitus, pancreatectomy, pancreatic insufficiency, pancreaticoduodenectomy, Whipple's procedure | 397 WU et al.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Forest plot of studies indicating incidence of new‐onset DM after each type of resection. A, Pancreaticoduodenectomy . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

“…Incidence 9%‐24% (pooled estimate 16%; 95% CI: 14%‐17%), Q = 18.20; P = .31, I 2 = 12.10%. B, Distal pancreatectomy performed for resection of neoplasm . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

“…Incidence 3%‐40% (pooled estimate 21%; 95% CI: 16%‐25%), Q = 124.97; P = <.01, I 2 = 85.60%. C, Central pancreatectomy . Random effects model.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Nahm

Jamieson

et al. 2020

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Major concerns with this surgical approach are the occurrence of pancreatic fistulas and the inability to properly assess the regional lymph nodes [47][48][49][50]. Lastly, central pancreatectomy can be performed for pNETs lesions that lie in the pancreatic neck or body and are in close proximity with the pancreatic duct [51][52][53][54].…”

Section: Treatment Resectable Diseasementioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: an Update

2015

View full text Add to dashboard Cite

Pancreatic neuroendocrine tumors (pNETs) are rare and comprise only 1-2 % of all pancreatic neoplastic disease. Although the majority of these tumors are sporadic (90 %), pNETs can arise in the setting of several different hereditary genetic syndromes, most commonly multiple endocrine neoplasia type 1 (MEN1). The presentation of pNETs varies widely, with over 60 % having malignant distant disease at the time of initial diagnosis involving the liver or other distant sites. Functioning pNETs represent approximately 10 % of all pNETs, secrete a variety of peptide hormones, and are responsible for several clinical syndromes caused by profound hormonal derangement. Surgery remains the cornerstone of therapy and the only curative approach. It should be pursued for localized disease and for metastatic lesions amenable to resection. Multimodality therapies, including liver-directed therapies and medical therapy, are gaining increasing favor in the treatment of advanced pNETs. Their utility is multifold and spans from ameliorating symptoms of hormonal excess (functional pNETs) to controlling the local and systemic disease burden (non-functional pNETs). The recent introduction of target molecular therapy has promising results especially for the treatment of progressive well-differentiated G1/G2 tumor. In this review, we summarize the current knowledge and give an update on recent advancements made in the therapeutic strategies for pNETs.

show abstract

Comparison between robot‐assisted middle pancreatectomy and robot‐assisted distal pancreatectomy for benign or low‐grade malignant tumours located in the neck of the pancreas: A propensity score matched study

Shi

Wang

Shi

et al. 2021

Robotics Computer Surgery

View full text Add to dashboard Cite

Objective To compare the short‐term and long‐term outcomes between robot‐assisted middle pancreatectomy (RMP) and robot‐assisted distal pancreatectomy (RDP). Methods From August 2010 to May 2018, more than 800 patients were diagnosed with benign or low‐grade malignant pancreatic tumours. According to the inclusion criteria, a total of 164 patients were included in our study. Among them 123 patients received RMP and 41 patients received RDP with spleen‐preserving. These patients were divided into two groups, and propensity score matching (PSM) was used to minimize bias. Short‐term and long‐term outcomes were recorded and analysed. Results After 1:1 matching, 38 cases of RMP and RDP were recorded and the baseline data was balanced. In the RMP group, 14 patients (36.8%) were female. In the RDP group, 13 patients (34.2%) were female. RDP had advantages in short‐term outcomes including overall morbidity (28.9% vs. 60.5%, p = 0.011), Severe morbidity (0 vs. 10.5%, p = 0.017), clinical‐relevant postoperative pancreatic fistula (CR‐POPF) rate (10.5% vs. 36.8%, p = 0.007) and postoperative length of hospital stay (16.5 ± 8.6 days vs. 23.6 ± 12.9 days, p = 0.006). The operative time was similar; however, there were less estimated blood loss (EBL) in RMP group (31.3 ± 33.0 ml vs. 62.3 ± 38.2 ml, p<0.001). Patients in these two groups had a similar result in preservation of the pancreatic function. There was no statistic difference in incidence rate of exocrine and endocrine insufficiency between two groups (2.6% vs. 7.9%, p = 0.608; 5.3% vs. 10.5%, p = 0.671). Conclusion For benign or low‐grade malignant tumours located at the neck of the pancreas, RMP and RDP could both be considered. The morbidity especially CR‐POPF rate after RDP would be lower, but RMP would be more helpful in reducing EBL. RMP should be chosen with caution as it did not show a huge advantage in preserving normal pancreatic function. Further prospective randomised studies should be designed to compare these two types of surgery.

show abstract

Middle segmental pancreatectomy: A safe and organ-preserving option for benign and low-grade malignant lesions

Abstract: MSP is a safe and organ-preserving option for benign or low-grade malignant lesions in the neck and proximal body of the pancreas.

Cited by 37 publications

References 29 publications

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Risk factors for development of diabetes mellitus (Type 3c) after partial pancreatectomy: A systematic review

Pancreatic Neuroendocrine Tumors: an Update

Comparison between robot‐assisted middle pancreatectomy and robot‐assisted distal pancreatectomy for benign or low‐grade malignant tumours located in the neck of the pancreas: A propensity score matched study

Contact Info

Product

Resources

About