Document Detail


Better preservation of endocrine function after central versus distal pancreatectomy for mid-gland lesions.
MedLine Citation:
PMID:  21134558     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Traditional resections for benign and low-grade malignant neoplasms of the mid pancreas result in loss of normal parenchyma that can cause pancreatic endocrine and exocrine insufficiency. Central pancreatectomy (CP) is a parenchyma-sparing option for such lesions. This study evaluates a single institution's experience with CP and compares outcomes with distal pancreatectomy (DP).
METHODS: We retrospectively collected data on CP patients from 1997 through 2009 and evaluated outcomes. In a subset of 50 patients, we performed a matched-pairs analysis to directly compare the short- and long-term outcomes of CP and DP.
RESULTS: Seventy-three patients underwent CP with a median operating room time of 254 minutes. Overall morbidity was 41.1% with pancreatic fistula in 20.5%. Mortality was 0%. There were no differences in fistula, morbidity, and mortality rates between the CP and DP groups. The CP group had resected for smaller lesions. CP patients had a lower rate of new-onset and worsening diabetes than DP patients (14% vs 46%; P = .003). Of new-onset and worsening diabetics, only 1 CP patient required insulin compared with 14 DP patients (P = .002).
CONCLUSION: CP is safe and effective for select neoplasms of the mid pancreas. Patients undergoing CP have markedly decreased insulin requirements compared with DP patients.
Authors:
Joseph DiNorcia; Leaque Ahmed; Minna K Lee; Patrick L Reavey; Elizabeth A Yakaitis; James A Lee; Beth A Schrope; John A Chabot; John D Allendorf
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  148     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-07     Completed Date:  2011-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1247-54; discussion 1254-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Continental Population Groups
Cysts / surgery
Diabetes Mellitus / epidemiology,  etiology
Disease Progression
Drainage / methods
Female
Humans
Male
Middle Aged
Neoplasm Invasiveness
Pancreatectomy / methods*,  standards
Pancreatic Diseases / surgery*
Pancreatic Fistula / surgery*
Pancreatic Neoplasms / pathology,  surgery
Postoperative Complications / classification,  therapy
Retrospective Studies
Safety
Sepsis / epidemiology
Treatment Outcome
Grant Support
ID/Acronym/Agency:
T32 HL-007854-14/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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