Middle Pancreatectomy of 15 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Jin , DAI Xianwei , BU Xianmin

Hepato-Pancreato-Biliary Tumor and Transplantation Department, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, China;

Corresponding author：

Keywords：

Tumor of pancreatic neck; Middle pancreatectomy; Pancreatic fistula; Pancreaticojejunostomy

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Objective To summarize the experiences of middle pancreatectomy. Methods Eleven female and 4 male with a mean age of 49.4 years (23.8-73.1 years) who underwent middle pancreatectomy from January 2001 to October 2005 were collected. Eight patients with neuroendocrine tumor (non-function of 5 cases), 5 with serous cystadenomas and 2 with mucinous cystadenomas were included. The proximal apical end of pancreas was sutured, while distal end of pancreas was anastomosed to a Roux-en-Y jejunal loop. Results Mean operative time was 275 min (179-370 min), mean length of resected pancreas was 45 mm (30-60 mm) and max diameter of tumor was 23 mm (15-40 mm). Complication after operation was pancreatic fistula 〔4 cases (26.7%)〕, in which 3 cases (20.0%) had intraabdominal blood. The mean time of follow-up was 23 months (3 months-5 years). one patient was died of multiple organs failure for pulmonary infections in month 3 after operation, and the others were alive without novo-diabetes. Conclusion Middle pancreatectomy is an effective operation for benign and borderline tumors of neck and body of pancreas without a significant increase of postoperative morbidity.

Citation： XU Jin,DAI Xianwei,BU Xianmin. Middle Pancreatectomy of 15 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(6): 478-480. doi: Copy

1.	Guillemin P, Bessot M. Chronic calcifying pancreatitis in renal tuberculosis: pancreatojejunostomy using an original technic [Ｊ]. Mem Acad Chir (Paris)， 1957; 83(27-28): 869-871.
2.	Letton AH, Wilson JP. Traumatic severance of pancreas tr-eated by Roux-Y anastomosis [Ｊ]. Surg Gynecol Obstet, 1959; 109: 473-478.
3.	Adham M, Giunippero A, Hervieu V, et al. Central pancreatectomy: single-center experience of 50 cases [Ｊ]. Arch Surg, 2008; 143(2): 175-180.
4.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey [Ｊ]. Ann Surg, 2004; 240(2): 205-213.
5.	Celis J, Berrospi F, Ruiz E, et al. Central pancreatectomy for tumors of the neck and body of the pancreas [Ｊ]. J Surg Oncol, 2001; 77(2): 132-135.
6.	Goldstein MJ, Toman J, Chabot JA. Pancreaticogastrostomy: a novel application after central pancreatectomy [Ｊ]. J Am Coll Surg, 2004; 198(6): 871-876.
7.	Jalleh RP, Williamson RC. Pancreatic exocrine and endocrine function after operations for chronic pancreatitis [Ｊ]. Ann Surg, 1992; 216(6): 656-662.
8.	Sun AM, Coddling JA, Haist RE. A study of glucose tolerance and insulin response in partially depancreatized dogs [Ｊ]. Diabetes, 1974; 23(5): 424-432.
9.	Lynch AM, Kapila R. Overwhelming postsplenectomy infection [Ｊ]. Infect Dis Clin North Am, 1996; 10(4): 693-707.
10.	Ziemski JM, Rudowski WJ, Jaskowiak W, et al. Evaluation of early postsplenectomy complications [Ｊ]. Surg Gynecol Obstet, 1987; 165(6): 507-514.
11.	Warshaw AL. Conservation of the spleen with distal pancreatectomy [Ｊ]. Arch Surg, 1988; 123(5): 550-553.
12.	Kimura W, Fuse A, Hirai I, et al. Spleen-preserving distal pancreatectomy with preservation of the splenic artery and vein for intraductal papillary-mucinous tumor (IPMT): three interesting cases [Ｊ]. Hepatogastroenterology, 2003; 50(54): 2242-2245.
13.	da Cunha JE, Machado MC, Penteado S, et al. Distal pancreatectomy without splenectomy and with preservation of splenic vessels [Ｊ]. Hepatogastroenterology, 2000; 47(35): 1444-1446.
14.	Kimura W, Inoue T, Futakawa N, et al. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein [Ｊ]. Surgery, 1996; 120(5): 885-890.
15.	Rotman N, Sastre B, Fagniez PL. Medial pancreatectomy for tumors of the neck of the pancreas [Ｊ]. Surgery, 1993; 113(5): 532-535.
16.	Iacono C, Bortolasi L, Serio G. Is there a place for central pancreatectomy in pancreatic surgery? [Ｊ]. J Gastrointest Surg, 1998; 2(6): 509-517.
17.	Ikeda S, Matsumoto S, Maeshiro K, et al. Segmental pancreatectomy for the diagnosis and treatment of small lesions in the neck or body of the pancreas [Ｊ]. Hepatogastroenterology, 1995; 42(5): 730-733.
18.	Sperti C, Pasquali C, Ferronato A, et al. Median pancreatectomy for tumors of the neck and body of the pancreas [Ｊ]. J Am Coll Surg, 2000; 190(6): 711-716.
19.	Sauvanet A, Partensky C, Sastre B, et al. Medial pancreatectomy: a multi-institutional retrospective study of 53 patients by the French Pancreas Club [Ｊ]. Surgery, 2002; 132(5): 836-843.
20.	de Clavière G, Paye F, Fteriche S, et al. Medial pancreatectomy: results of a series of 11 patients [Ｊ]. Ann Chir, 2002; 127(1): 48-54.
21.	杜正贵, 李波, 冯曦, 等. 胰十二指肠切除术后上消化道大出血的原因及对策 [Ｊ]. 中国普外基础与临床杂志, 2008； 15(7): 511-514.
22.	Sledzianowski JF, Duffas JP, Muscari F, et al. Risk factors for mortality and intra-abdominal morbidity after distal pancreatectomy [Ｊ]. Surgery, 2005; 137(2): 180-185.
23.	Bassi C, Falconi M, Salvia R, et al. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients [Ｊ]. Dig Surg, 2001; 18(6): 453-458.
24.	Büchler MW, Bassi C, Fingerhut A, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? [Ｊ]. Ann Surg, 2001; 234(2): 262-263.
25.	吕飞飞, 赵海平. 胰十二指肠切除术的早期并发症及危险因素分析(附71例报告) [Ｊ]. 中国普外基础与临床杂志, 2008； 15(3): 205-206.

1. Guillemin P, Bessot M. Chronic calcifying pancreatitis in renal tuberculosis: pancreatojejunostomy using an original technic [Ｊ]. Mem Acad Chir (Paris)， 1957; 83(27-28): 869-871.
2. Letton AH, Wilson JP. Traumatic severance of pancreas tr-eated by Roux-Y anastomosis [Ｊ]. Surg Gynecol Obstet, 1959; 109: 473-478.
3. Adham M, Giunippero A, Hervieu V, et al. Central pancreatectomy: single-center experience of 50 cases [Ｊ]. Arch Surg, 2008; 143(2): 175-180.
4. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey [Ｊ]. Ann Surg, 2004; 240(2): 205-213.
5. Celis J, Berrospi F, Ruiz E, et al. Central pancreatectomy for tumors of the neck and body of the pancreas [Ｊ]. J Surg Oncol, 2001; 77(2): 132-135.
6. Goldstein MJ, Toman J, Chabot JA. Pancreaticogastrostomy: a novel application after central pancreatectomy [Ｊ]. J Am Coll Surg, 2004; 198(6): 871-876.
7. Jalleh RP, Williamson RC. Pancreatic exocrine and endocrine function after operations for chronic pancreatitis [Ｊ]. Ann Surg, 1992; 216(6): 656-662.
8. Sun AM, Coddling JA, Haist RE. A study of glucose tolerance and insulin response in partially depancreatized dogs [Ｊ]. Diabetes, 1974; 23(5): 424-432.
9. Lynch AM, Kapila R. Overwhelming postsplenectomy infection [Ｊ]. Infect Dis Clin North Am, 1996; 10(4): 693-707.
10. Ziemski JM, Rudowski WJ, Jaskowiak W, et al. Evaluation of early postsplenectomy complications [Ｊ]. Surg Gynecol Obstet, 1987; 165(6): 507-514.
11. Warshaw AL. Conservation of the spleen with distal pancreatectomy [Ｊ]. Arch Surg, 1988; 123(5): 550-553.
12. Kimura W, Fuse A, Hirai I, et al. Spleen-preserving distal pancreatectomy with preservation of the splenic artery and vein for intraductal papillary-mucinous tumor (IPMT): three interesting cases [Ｊ]. Hepatogastroenterology, 2003; 50(54): 2242-2245.
13. da Cunha JE, Machado MC, Penteado S, et al. Distal pancreatectomy without splenectomy and with preservation of splenic vessels [Ｊ]. Hepatogastroenterology, 2000; 47(35): 1444-1446.
14. Kimura W, Inoue T, Futakawa N, et al. Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein [Ｊ]. Surgery, 1996; 120(5): 885-890.
15. Rotman N, Sastre B, Fagniez PL. Medial pancreatectomy for tumors of the neck of the pancreas [Ｊ]. Surgery, 1993; 113(5): 532-535.
16. Iacono C, Bortolasi L, Serio G. Is there a place for central pancreatectomy in pancreatic surgery? [Ｊ]. J Gastrointest Surg, 1998; 2(6): 509-517.
17. Ikeda S, Matsumoto S, Maeshiro K, et al. Segmental pancreatectomy for the diagnosis and treatment of small lesions in the neck or body of the pancreas [Ｊ]. Hepatogastroenterology, 1995; 42(5): 730-733.
18. Sperti C, Pasquali C, Ferronato A, et al. Median pancreatectomy for tumors of the neck and body of the pancreas [Ｊ]. J Am Coll Surg, 2000; 190(6): 711-716.
19. Sauvanet A, Partensky C, Sastre B, et al. Medial pancreatectomy: a multi-institutional retrospective study of 53 patients by the French Pancreas Club [Ｊ]. Surgery, 2002; 132(5): 836-843.
20. de Clavière G, Paye F, Fteriche S, et al. Medial pancreatectomy: results of a series of 11 patients [Ｊ]. Ann Chir, 2002; 127(1): 48-54.
21. 杜正贵, 李波, 冯曦, 等. 胰十二指肠切除术后上消化道大出血的原因及对策 [Ｊ]. 中国普外基础与临床杂志, 2008； 15(7): 511-514.
22. Sledzianowski JF, Duffas JP, Muscari F, et al. Risk factors for mortality and intra-abdominal morbidity after distal pancreatectomy [Ｊ]. Surgery, 2005; 137(2): 180-185.
23. Bassi C, Falconi M, Salvia R, et al. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients [Ｊ]. Dig Surg, 2001; 18(6): 453-458.
24. Büchler MW, Bassi C, Fingerhut A, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? [Ｊ]. Ann Surg, 2001; 234(2): 262-263.
25. 吕飞飞, 赵海平. 胰十二指肠切除术的早期并发症及危险因素分析(附71例报告) [Ｊ]. 中国普外基础与临床杂志, 2008； 15(3): 205-206.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Middle Pancreatectomy of 15 Cases

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