Segmental pancreatectomy for benign tumor of the pancreas.

Cheng-Hsi Su, Yi-Ming Shyr, Wing-Yiu Lui, Fang-Ku P'eng
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Abstract

Background: Enucleation of pancreatic tumor has the potential risk for damage of the main pancreatic duct. Benign tumors located in the neck or body of the pancreas are usually removed by left (spleno-) pancreatectomy or pancreatoduodenectomy. Standard pancreatic resection may result in serious loss of normal pancreatic parenchyme and impairment of pancreatic function. The aim of this study is to evaluate the results of segmental pancreatectomy, a limited resection of the midportion of the pancreas, in patients with benign tumor of the pancreas.

Methods: Four patients with benign tumor over pancreatic neck or body were treated with segmental pancreatectomy after pathological confirmation by frozen section. The proximal stump was closed and distal stump was anastomosed with a Roux-en-Y pancreaticojejunostomy. Clinical evaluation, routine blood sugar, stool fat examination and abdominal ultrasonography were performed for their follow up.

Results: Segmental pancreatectomy was satisfactory in these four patients. The pathologic examinations revealed serous cystadenoma. No mortality was noted. Minor pancreatic fistula was found in three of them and was treated conservatively. No obvious exocrine insufficiency was noticed. One patient had diabetes mellitus before operation, which was persisted postoperatively.

Conclusions: Segmental pancreatectomy is a safe and effective alternative to major pancreatic resection in selected patients with benign tumor of the pancreas. This procedure has a surgical risk similar to that of the standard operation, but preserves more pancreatic tissues, which may prevent pancreatic function impairment.

胰腺良性肿瘤的节段性胰切除术。
背景:胰腺肿瘤去核有损伤主胰管的潜在危险。位于胰腺颈部或胰腺体的良性肿瘤通常通过左(脾)胰腺切除术或胰十二指肠切除术切除。标准胰腺切除术可能导致正常胰腺实质的严重丧失和胰腺功能的损害。本研究的目的是评估胰腺良性肿瘤患者行节段性胰腺切除术的结果,这是一种有限切除胰腺中部的方法。方法:对4例胰腺颈部或胰腺体良性肿瘤,经冰冻切片病理证实后行胰段性切除术。近端残端闭合,远端残端采用Roux-en-Y胰空肠吻合术吻合。临床评价、常规血糖、粪便脂肪检查及腹部超声检查进行随访。结果:4例患者胰段切除术效果满意。病理检查显示浆液性囊腺瘤。没有发现死亡率。其中3例发现轻微胰瘘,予以保守治疗。未见明显外分泌不足。1例患者术前有糖尿病,术后持续存在。结论:对于特定的胰腺良性肿瘤患者,节段性胰腺切除术是一种安全有效的替代胰腺大切除术的方法。该手术的手术风险与标准手术相似,但保留了更多的胰腺组织,可以防止胰腺功能损害。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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