title: Central pancreatectomy versus spleen-preserving distal pancreatectomy: a comparative analysis of early and late postoperative outcomes.
abstract: OBJECTIVE
  The aim of the present study is to compare the postoperative and long-term outcomes of central pancreatectomy (CP) and spleen-preserving distal pancreatectomy (SPDP).
  
  
  METHODS
  Clinical, pathological and long-term data were compared between 22 patients who underwent CP and 25 patients who underwent SPDP (2002-2012).
  
  
  RESULTS
  The median length of resected pancreas was 8.5 cm in the SPDP group and 5 cm in the CP group (p < 0.001). The median estimated blood loss was significantly lower in the CP group (p = 0.019). Morbidity was 50% for CPs and 40% for SPDPs (p = 0.564). The rate of pancreatic fistulae was 36% for CPs and 40% for SPDPs (p = 0.530). The rate of new-onset diabetes was nil in the successful CP group and 16% in the SPDP group (p = 0.111).
  
  
  CONCLUSIONS
  Morbidity and pancreatic fistula rates are not higher after CP when compared to SPDP. The loss of normal pancreatic tissue is significantly lower for CP, and thus there is potentially better preservation of the pancreatic endocrine functions. CP should be considered only in selected cases when preservation of the pancreas is of utmost importance, especially for lesions situated at the level of the pancreatic neck.
authors.affiliation: Center of General Surgery and Liver Transplant, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Traian
authors.initials: T
authors.lastname: Dumitrascu
authors.forename: Andra
authors.initials: A
authors.lastname: Scarlat
authors.forename: Mihnea
authors.initials: M
authors.lastname: Ionescu
authors.forename: Irinel
authors.initials: I
authors.lastname: Popescu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D003920:Diabetes Mellitus / Q000209:etiology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D059351:Organ Sparing Treatments; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D013156:Splenectomy; D013997:Time Factors; D055815:Young Adult