Evaluation of central versus distal pancreatectomy in management of pancreatic body tumours: A combined retrospective and prospective study

Abstract

. ABSTRACT Background: Central pancreatectomy is a promising surgical option for patients with benign and low-grade neoplasms affecting the pancreatic body/neck region, as it preserves more pancreatic parenchyma than distal pancreatectomy. However, dealing with two pancreatic stumps carries an increased potential for pancreatic fistula. That is why we conducted this investigation to compare the previous two techniques (central vs. distal pancreatectomy) in patients with such neoplasms. Patients and Methods: Seventy patients were enrolled in our combined prospective and retrospective trial. Group A included 35 central pancreatectomy patients, while Group B included 35 distal pancreatectomy patients. Results: Central pancreatectomy was associated with a prolonged operative time compared to the distal procedure. Tumor size and pathology did not differ between the two groups. However, the length of the resected pancreatic tissue was shorter in Group A. Patients in the same group had longer ICU stays, hospitalization periods, and longer duration till oral intake. However, the incidence of pancreatic fistula was comparable between the two groups (22.9% vs. 25.7% in the two groups, respectively). Other complications, including hemorrhage and wound infection, did not differ between the two groups. Mortality occurred in only one patient in Group A due to secondary hemorrhage. Both endocrine and exocrine insufficiencies were more encountered after distal pancreatectomy compared to the central one. Conclusion: Central pancreatectomy is associated with significantly better postoperative pancreatic endocrine and exocrine functions without increased complication rates compared to distal pancreatectomy.