title: Parenchyma-Sparing Pancreatic Resections: With or Without a Pancreaticojejunostomy?
abstract: OBJECTIVE
  Parenchyma-sparing pancreatic resections are used in low-grade malignant tumors, but result in a high incidence of pancreatic fistula. Pancreaticojejunostomy to the site of resection might decrease the risk of pancreatic fistula. The purpose of this study was to evaluate the influence of pancreaticojejunostomy on the outcomes of parenchyma-sparing resections.
  
  
  METHODS
  The study group consisted of 21 patients (M/F = 4:17, mean age = 47 years). Local tumor resection with a pancreaticojejunostomy was performed in 11 patients and enucleation in 10 patients. Both groups were compared retrospectively with regard to perioperative variables.
  
  
  RESULTS
  The operative time was significantly shorter in the enucleation group (median 180 min vs. 222 min, P = 0.005). The overall surgical morbidity was similar in both groups (81% vs. 70%, P = 0.64). The rate of clinically significant pancreatic fistula (64% vs. 40%, P = 0.39), hemorrhagic complications (27% vs. 10%, P = 0.59) and wound infection (18% vs. 40%, P = 0.36) were comparable in both groups. One patient died after central pancreatectomy. There were no new-onset cases of diabetes mellitus postoperatively.
  
  
  CONCLUSIONS
  Local resection combined with pancreaticojejunostomy is an option to avoid extensive resection of the pancreatic parenchyma, but is still associated with a high incidence of pancreatic fistula which is comparable to that after enucleation.
authors.forename: Marek
authors.initials: M
authors.lastname: Wroński
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Cebulski
authors.forename: Ireneusz W
authors.initials: IW
authors.lastname: Krasnodębski
authors.forename: Maciej
authors.initials: M
authors.lastname: Słodkowski
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010185:Pancreatic Fistula / Q000453:epidemiology; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000401:mortality; D011044:Poland / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome