Conservative resection for benign tumors of the proximal pancreas.
OBJECTIVE
To evaluate the safety and long-term prognosis of conservative resection (CR) for benign or borderline tumor of the proximal pancreas.


METHODS
We retrospectively analyzed 20 patients who underwent CR at the Second Affiliated Hospital of Zhejiang University School of Medicine between April 2000 and October 2008. For pancreaticojejunostomy, a modified invagination method, continuous circular invaginated pancreaticojejunostomy (CCI-PJ) was used. Modified continuous closed lavage (MCCL) was performed for patients with pancreatic fistula.


RESULTS
The indications were: serous cystadenomas in eight patients, insulinomas in six, non-functional islet cell tumors in three and solid pseudopapillary tumors in three. Perioperative mortality was zero and morbidity was 25%. Overall, pancreatic fistula was present in 25% of patients. At a mean follow up of 42.7 mo, all patients were alive with no recurrence and no new-onset diabetes mellitus or exocrine dysfunction.


CONCLUSIONS
CR is a safe and effective procedure for patients with benign tumors in the proximal pancreas, with careful CCI-PJ and postoperative MCCL.
Huang
Hai
H
Department of Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China.
Dong
Xin
X
Gao
Shun-Liang
SL
Wu
Yu-Lian
YL
D000328:Adult; D000368:Aged; D018293:Cystadenoma, Serous / Q000601:surgery; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000601:surgery; D007515:Islets of Langerhans / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000295:instrumentation* / Q000379:methods*; D010185:Pancreatic Fistula / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010193:Pancreaticojejunostomy / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome
Ann Surg. 1993 Sep;218(3):229-37; discussion 237-8
8103982
Ann Surg. 2000 Jun;231(6):890-8
10816633
Arch Surg. 2006 Mar;141(3):293-9
16549696
Pancreas. 2008 Jan;36(1):44-9
18192880
J Hepatobiliary Pancreat Surg. 2000;7(5):466-72
11180872
Br J Surg. 2000 Apr;87(4):434-8
10759738
J Am Coll Surg. 1994 Nov;179(5):545-52
7952456
HPB (Oxford). 2006;8(2):142-7
18333263
J Gastrointest Surg. 1998 Nov-Dec;2(6):509-16; discussion 516-7
10457309
Surgery. 1984 Oct;96(4):608-16
6435270
Diabet Med. 1998 Jul;15(7):539-53
9686693
Ann Surg. 1976 Oct;184(4):403-13
1015887
Ann Surg. 1995 Oct;222(4):580-8; discussion 588-92
7574936
Br J Surg. 2000 Jul;87(7):883-9
10931023
J Gastrointest Surg. 2004 Jul-Aug;8(5):532-8
15239986
Arch Surg. 1998 Mar;133(3):327-31
9517749
J Gastrointest Surg. 2006 Jun;10(6):804-12
16769536
Br J Surg. 2008 Jan;95(1):85-91
18041022
Br J Surg. 2007 Oct;94(10):1254-9
17583892
J Am Coll Surg. 2000 Jun;190(6):711-6
10873007
Am J Surg. 1995 Jan;169(1):179-85
7817989
J Gastrointest Surg. 2007 Dec;11(12):1704-11
17929105
Surgery. 1993 May;113(5):532-5
8488471
Dig Surg. 2003;20(6):506-10
14506331
Surgery. 2002 Nov;132(5):836-43
12464868