期刊
SURGERY
卷 148, 期 6, 页码 1247-1254出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.surg.2010.09.003
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类别
资金
- Ruth L. Kirschstein National Research Service Award [T32 HL-007854-14]
- Doris Duke Charitable Foundation
- I.W. Foundation
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 TOM 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. (Surgery 2010;148:1247-56.)
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