Medial pancreatectomy for tumors of the neck of the pancreas.
BACKGROUND
The surgical treatment of benign tumors of the pancreas usually consists of enucleation or formal pancreatectomy. Nonetheless, enucleation is not always feasible, and extended pancreatectomies may result in impaired endocrine and exocrine function.


METHODS
For these reasons we proposed a limited resection centered on the neck of the pancreas with complete excision of the tumor. The cephalic section was sutured, and a Roux-en-Y jejunal loop was anastomosed to the distal section of the pancreas. Fourteen patients were operated on by this technique. The tumors were mainly cystadenomas (n = 6) and endocrine tumors (n = 4). The other lesions were one epithelial cyst, one necrotic pseudocyst, one Castleman disease, and one cystadenocarcinoma diagnosed after surgery on histologic examination.


RESULTS
No patients died. Two patients underwent reoperation: one for a postoperative acute pancreatitis and one for a pancreatic fistula. All patients were followed up from 4 months to 8 years. No patients had exocrine insufficiency or diabetes mellitus.


CONCLUSIONS
Medial pancreatectomy does not carry a higher operative risk than formal pancreatectomy and avoids extensive pancreatic resection when enucleation is not feasible.
Rotman
N
N
Service de chirurgie digestive, Hopital Henri Mondor, Créteil, France.
Sastre
B
B
Fagniez
P L
PL
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003536:Cystadenocarcinoma / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation
D001786:Blood Glucose