| Better preservation of endocrine function after central versus distal pancreatectomy for mid-gland lesions. | |
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MedLine Citation:
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PMID: 21134558 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Surgery Volume: 148 ISSN: 1532-7361 ISO Abbreviation: Surgery Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-07 Completed Date: 2011-01-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
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Languages: eng Pagination: 1247-54; discussion 1254-6 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, NY, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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