Purpose: Pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) are treatmentsused for pancreatic benign neoplasms even though both of these treatments result insignificant loss of normal pancreatic parenchyma; this leads to subsequent impairment ofexocrine and endocnne pancreaticfunction. The purpose ofthis study is to provide short- andlong-term result of limited resection (LR) in a single center.
Methods: Two-hundred thirty patients who had undergone pancreatic resection betweenApril 1998 and September 2008 for benign neoplasms were reviewed retrospectively. DP wasperformed in 102 patients, LR in 77, PD in 51 patients. The definitions of the IntemationalStudy Group of Pancreatic Fistula (ISGPF) were applied to postoperative pancreatic fistulas(POPF), Perioperatve endocrine function was evaluated through oral glucose tolerance test.
ResuHs: LR includes 42 enucleation, 24 central pancreatectomy, and 11 uncinate processresection. No deaths occurred to patients duhng the study review period; POPF was detectedin 50 patients (65%), 37 patients with grade A and 13 patients with grade B or C. POPFoccurred 65% of the time after LR, more frequently compared to the occurrance after PD orDP (58%), but this was not statistically significant (P =.322). After LR, there were 2 patientswith new onset diabetes (3%), while 26 (17%) Patients developed diabetes after DP or PD (P= .002).
Conclusion: LR may preserve endocrine and exocrine function. While mortality is low withthe use of LR, it is associated with a higher pancreatic-leakage rate. The precisemanagement of benign pancreatic lesions remains in evolution.
|