Comparative Analysis of Limited Resection and Conventional Resection for Pancreatic Benign Lesions Focused on Perioperative Diabetes and Pancreatic Fistula.
- Author:
Min Young CHOI
1
;
Dong Do YOU
;
Hyung Geun LEE
;
Jin Seok HEO
;
Seong Ho CHOI
;
Dong Wook CHOI
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sh3468.choi@samsung.com
- Publication Type:Original Article
- Keywords:
Limited resection;
Enucleation;
Central pancreatectomy;
Ventral pancreatectomy
- MeSH:
Glucose Tolerance Test;
Humans;
Pancreatectomy;
Pancreatic Fistula;
Pancreaticoduodenectomy;
Retrospective Studies
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2009;13(3):179-183
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) are treatments used for pancreatic benign neoplasms even though both of these treatments result in significant loss of normal pancreatic parenchyma; this leads to subsequent impairment of exocrine and endocrine pancreatic function. The purpose of this study is to provide short-and long-term result of limited resection (LR) in a single center. METHODS: Two-hundred thirty patients who had undergone pancreatic resection between April 1998 and September 2008 for benign neoplasms were reviewed retrospectively. DP was performed in 102 patients, LR in 77, PD in 51 patients. The definitions of the International Study Group of Pancreatic Fistula (ISGPF) were applied to postoperative pancreatic fistulas (POPF), perioperative endocrine function was evaluated through oral glucose tolerance test. RESULTS: LR includes 42 enucleation, 24 central pancreatectomy, and 11 uncinate process resection. No deaths occurred to patients during the study review period; POPF was detected in 50 patients (65%), 37 patients with grade A and 13 patients with grade B or C. POPF occurred 65% of the time after LR, more frequently compared to the occurrance after PD or DP (58%), but this was not statistically significant (P =.322). After LR, there were 2 patients with new onset diabetes (3%), while 26 (17%) patients developed diabetes after DP or PD (P = .002). CONCLUSION: LR may preserve endocrine and exocrine function. While mortality is low with the use of LR, it is associated with a higher pancreatic-leakage rate. The precise management of benign pancreatic lesions remains in evolution.
