title: Clinical significance of circumportal pancreas, a rare congenital anomaly, in pancreatectomy.
abstract: BACKGROUND
  Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy.
  
  
  METHODS
  The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The prevalence of circumportal pancreas and related anatomical variations were assessed. Surgical procedures and postoperative outcomes were compared in patients with and without circumportal pancreas.
  
  
  RESULTS
  Circumportal pancreas was observed in 9 of the 508 patients (1.7%). In all nine patients, the portal vein was completely encircled by the pancreatic parenchyma above the level of the splenoportal junction, and the main pancreatic duct ran dorsal to the portal vein. The rate of variant hepatic artery did not differ significantly in patients with and without circumportal pancreas. Pancreatic fistula developed more frequently in patients with than without circumportal pancreas (44% vs. 14%, p = 0.03), but other clinical parameters did not differ significantly in these two groups.
  
  
  CONCLUSIONS
  Despite being rare, circumportal pancreas may increase the risk of postoperative pancreatic fistula in patients undergoing pancreatectomy. However, a prospective, large-cohort study is necessary to determine the real incidence of relevant anatomical variations and the definitive clinical significance of this rare anomaly.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan; Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, Japan. Electronic address: takao-o@surg1.med.kyushu-u.ac.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Ohtsuka
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Kousei
authors.initials: K
authors.lastname: Ishigami
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Fujimoto
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyasaka
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakata
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Kenoki
authors.initials: K
authors.lastname: Ohuchida
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Eishi
authors.initials: E
authors.lastname: Nagai
authors.affiliation: Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
authors.affiliation: Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, Japan; International Medical Department, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan. Electronic address: mnaka@surg1.med.kyushu-u.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities*; D010180:Pancreatectomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Circumportal pancreas; Pancreatectomy; Pancreatic fistula; Portal annular pancreas