Pancreaticogastrostomy: a novel application after central pancreatectomy.
BACKGROUND
Limited middle segment pancreatectomy, or central pancreatectomy, has been described for sparing normal pancreatic tissue during resection of benign neoplasms of the pancreatic neck. Anatomic reconstruction after central pancreatectomy has been reported in other series with creation of a Roux-en-Y loop of jejunum for a mucosa-to-mucosa pancreaticojejunostomy.


METHODS
Hospital charts and outpatient records were reviewed for 12 consecutive patients undergoing central pancreatectomy from August 1999 to November 2002.


RESULTS
We performed central pancreatectomy with pancreaticogastrostomy in 12 patients: 5 with serous cystadenomas, 6 with mucinous cystadenomas, and 1 with neuroendocrine tumor. All tumors were located in the body or neck of the pancreas, measuring a mean +/- standard deviation (SD) of 2.5 +/- 1.2 cm. Median postoperative hospital stay was 6.5 days (range 5 to 15 days). There were no intraoperative complications. Perioperative complications included two urinary tract infections and one readmission for acute pancreatitis. There were no pancreatic leaks or fistulas in this series. Two of the 12 patients experienced endocrine insufficiency with elevated glycosylated hemoglobin levels during outpatient followup. None of the 12 patients experienced exocrine insufficiency.


CONCLUSIONS
Central pancreatectomy with pancreaticogastrostomy reconstruction is safe and technically advantageous over Roux-en-Y pancreaticojejunostomy, and should be considered a safe reconstruction technique after central pancreatectomy for benign disease.
Goldstein
Michael J
MJ
Department of Surgery, New York Presbyterian Hospital, Columbia Campus, New York, NY 10032, USA.
Toman
Jared
J
Chabot
John A
JA
D000713:Anastomosis, Roux-en-Y; D018291:Cystadenoma, Mucinous / Q000601:surgery; D018293:Cystadenoma, Serous / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures; D013997:Time Factors