title: Indications and technique of central pancreatectomy-early and late results.
abstract: OBJECTIVE
  Central pancreatectomy (CP) is an operation that allows one to resect benign or low grade malignant tumours located in the pancreatic isthmus that are not suitable for enucleation. The main advantage of this operation compared with major resections is that it permits to spare normal pancreatic parenchyma.
  
  
  METHODS
  The operation is carried out by exposition of the pancreatic neck involved by the lesion. Thereafter, the gland is dissected from the splenic artery and porto-mesenteric axis and divided with a 1 cm clear margin. The cephalic stump is sutured, and the distal stump is anastomosed end-to-end or end-to-side with a Roux-en-Y jejunal loop. We treated 20 patients with this technique. The indications for CP were: serous cystadenoma in seven patients, mucinous in three, solid cystic papillary tumour in one, metastasis from renal cancer in one and endocrine tumour in eight patients.
  
  
  RESULTS
  Mortality rate was 0% and morbidity rate was 35%; pancreatic fistulas occurred in 25% of the cases and were treated conservatively. Results of postoperative endocrine and exocrine function tests were normal in all controlled patients. All the patients are alive without evidence of local recurrence.
  
  
  CONCLUSIONS
  CP is a safe technique for benign or low-grade malignant tumours of the pancreatic neck that allows one to cure the tumour with evident functional results without increasing the risk to the patient.
authors.affiliation: Department of Surgery and Gastroenterology, University of Verona Medical School, Verona, Italy. Calogero.Iacono@univr.it
authors.forename: Calogero
authors.initials: C
authors.lastname: Iacono
authors.forename: Luca
authors.initials: L
authors.lastname: Bortolasi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serio
mesh_terms: D000714:Anastomosis, Surgical; D018291:Cystadenoma, Mucinous / Q000601:surgery; D018293:Cystadenoma, Serous / Q000601:surgery; D006801:Humans; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome