title: Middle-segment-preserving pancreatectomy for biliary-pancreatic tumors.
abstract: OBJECTIVE
  Intraductal papillary mucinous neoplasm (IPMN) and pancreatic endocrine tumors can develop at multiple sites of the pancreas at the same time, sometimes necessitating total pancreatectomy. When low-grade pancreatic malignancy is treated surgically, preservation of function to improve long-term QOL is emphasized. For low grade malignancy tumor of the pancreatic head and tail, we performed middle- segment-preserving pancreatectomy (MSPP), with resection of the pancreatic head and tail alone, resulting in favorable QOL.
  
  
  METHODS
  MSPP was performed for 4 patients. Intraoperative blood loss, hospital stay, postoperative complications, histopathological findings and prognosis were examined.
  
  
  RESULTS
  Mean intraoperative blood loss was 1255 +/- 365g, mean hospital stay 61 +/- 53 days, and mortality 0%. Postoperatively, pancreatic fistula was observed in 3 patients, but subsided with conservative treatment. In one patient with diabetes preoperatively, diabetes was exacerbated postoperatively, necessitating insulin treatment. No postoperative onset of diabetes was observed. Percent change in body weight during the postoperative 6 month period from preoperative weight was 93 +/- 6.3%. One patient died of malignant lymphoma 1 year and 4 months after surgery. The other patients are alive and socially active.
  
  
  CONCLUSIONS
  MSPP enables maintenance of good QOL long after surgery for malignancy affecting the head and tail of the pancreas.
authors.affiliation: Department of Gastroenterological Surgery, Fujita Health University, Kutsukake-cho, Toyoake, Japan. akihori@fujita-hu.ac.jp
authors.forename: Akihiko
authors.initials: A
authors.lastname: Horiguchi
authors.forename: Shin
authors.initials: S
authors.lastname: Ishihara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Yukio
authors.initials: Y
authors.lastname: Asano
authors.forename: Koichi
authors.initials: K
authors.lastname: Furusawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyakawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*