title: Central pancreatectomy for benign or borderline lesions of the pancreatic neck: a single centre experience and literature review.
abstract: OBJECTIVE
  To investigate the effectiveness and safety of central pancreatectomy.
  
  
  METHODS
  We retrospectively studied 44 cases that underwent central pancreatectomy (CP), 55 patients who underwent distal pancreatectomy (DP), and 62 patients who underwent pancreatoduodenectomy (PD) for their benign or borderline pancreatic lesions; as well as the different management styles for pancreatic stumps in CP.
  
  
  RESULTS
  The duration of surgery and length of hospital stay were shorter in the CP group than that of PD group, and blood loss was also less in CP group. There were no differences between the CP and DP groups in duration of surgery, length of hospital stay, and blood loss. The incidence of common surgical complications was higher in the PD group. There were more pancreatic fistulas (grade B/C) in CP and PD groups compared to that of the DP group. New onset or worsening of diabetes occurred only in the CP and PD groups at 4.8% and 10.9%, respectively. A pancreaticogastrostomy for distal pancreatic stumps reduced the incidence of pancreatic fistula (p=0.038). Duct-to-mucosa anastomosis had less pancreatic fistula than invagination anastomosis (p=0.017). There was no difference in incidence of pancreatic fistula between pancreaticojejunostomy and oversewing of proximal pancreatic stumps (p=0.601).
  
  
  CONCLUSIONS
  CP is an available and safe operation for benign or borderline lesions located in the pancreatic neck. A pancreaticogastrostomy for distal pancreatic stumps or duct-to-mucosa anastomosis may reduce the risk of pancreatic fistula.
authors.affiliation: Department of Hepatobiliopancreatic Surgery, Sichuan University, Sichuan Province, China.
authors.forename: Guang-ming
authors.initials: GM
authors.lastname: Xiang
authors.forename: Chun-lu
authors.initials: CL
authors.lastname: Tan
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.forename: Xun
authors.initials: X
authors.lastname: Ran
authors.forename: Gang
authors.initials: G
authors.lastname: Mai
authors.forename: Xu-bao
authors.initials: XB
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies