Document Detail


Medial pancreatectomy: a multi-institutional retrospective study of 53 patients by the French Pancreas Club.
MedLine Citation:
PMID:  12464868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The results of medial pancreatectomy have been previously reported anecdotally. The purpose of the study was to provide short- and long-term results of MP in a large multicenter collective series. METHODS: From 1990 to 1998, 53 patients (mean age +/- SD = 49 +/- 15 years) underwent medial pancreatectomy for primary cystic neoplasms of pancreas (n = 19), endocrine neoplasms (n = 17), intraductal papillary mucinous neoplasms (IPMN) (n = 6), fibrotic stenosis of the Wirsung's duct (n = 4), or other benign (n = 4) or malignant (n = 3) diseases. The proximal (right) pancreatic remnant was sutured (n = 53), and the distal (left) remnant was either anastomosed to a jejunal loop (n = 26), to the stomach (n = 25), or oversewn (n = 2). Medial pancreatectomy was indicated in 3 patients (6%) because of failed enucleation, in 3 (6%) to prevent worsening of preexisting diabetes, or to prevent de novo diabetes in a patient with chronic pancreatitis, and deliberately in the 47 others. RESULTS: The length of the resected pancreas was 5.0+/- 2.2 cm (range, 2-15). One patient (2%) died from a pancreatic fistula and portal thrombosis. Three patients were reoperated on because of complications related to the left pancreas, which was partially or totally resected. Pancreatic fistula developed in 16 patients (30%). Mean delay for the return of oral feeding was related to the presence of a pancreatic fistula. At follow-up (median = 26 months, range, 12-131), 1 pancreatic recurrence and 1 de novo diabetes occurred in patients without IPMN. In patients with IPMN, the rates of pancreatic recurrence and diabetes were 40% (2/5), respectively. CONCLUSIONS: Medial pancreatectomy effectively preserves long-term endocrine function and is associated with a low risk of local recurrence, except in patients with IPMN. However, there is a high risk (30%) of PF after medial pancreatectomy.
Authors:
Alain Sauvanet; Christian Partensky; Bernard Sastre; Jean-François Gigot; Pierre-Louis Fagniez; Jean-Jacques Tuech; Bertrand Millat; Stéphane Berdah; Bertrand Dousset; Daniel Jaeck; Yves-Patrice Le Treut; Christian Letoublon
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Surgery     Volume:  132     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-12-04     Completed Date:  2003-01-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  836-43     Citation Subset:  AIM; IM    
Affiliation:
University Departments of Digestive Surgery of Hôpital Beaujon, Clichy; Hôpital Edouard Herriot, Lyon, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Diabetes Mellitus / etiology
Female
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
Pancreatectomy / adverse effects,  methods*
Pancreatic Fistula / etiology
Pancreatic Neoplasms / surgery
Postoperative Complications
Retrospective Studies
Treatment Outcome

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


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