A central pancreatectomy for benign or low-grade malignant neoplasms.
BACKGROUND
A central pancreatectomy is a parenchyma-sparing procedure that is performed to reduce long-term endocrine and exocrine insufficiency.


METHODS
In this study, we analyzed the perioperative course, the frequency of postoperative onset of diabetes mellitus, and long-term change of body weight in patients undergoing a central pancreatectomy, in comparison to the patients undergoing a distal pancreatectomy for low-grade neoplasms including cystic neoplasms and neuroendocrine tumors.


CONCLUSIONS
The rate of postoperative complications including grade B/C pancreatic fistula was no different between both groups. Only one patient undergoing a central pancreatectomy (4.7%) developed new onset of mild diabetes, whereas 35% in the distal pancreatectomy group developed new onset or worsening diabetes (p = 0.0129). The body weight in the distal pancreatectomy group was significant lower than that in the central pancreatectomy group at 1 and 2 years after surgery (1 year; P < 0.0001, 2 years; P = 0.0055), and the body weight in the patients undergoing a central pancreatectomy improved to preoperative values within 2 years after surgery.


CONCLUSIONS
A central pancreatectomy is a safe procedure for the treatment of low-grade malignant neoplasms in the pancreatic body; the rate of onset of diabetes is minimal, and the body weight improves early in the postoperative course.
Hirono
Seiko
S
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Tani
Masaji
M
Kawai
Manabu
M
Ina
Shinomi
S
Nishioka
Ryohei
R
Miyazawa
Motoki
M
Shimizu
Atsushi
A
Uchiyama
Kazuhisa
K
Yamaue
Hiroki
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010181:Pancreatic Cyst / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult