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Original communication| Volume 113, ISSUE 5, P532-535, May 1993

Medial pancreatectomy for tumors of the neck of the pancreas

  • Nelly Rotman
    Correspondence
    Reprint requests: N. Rotman, MD, Service de chirurgie digestive, Hopital Henri-Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
    Affiliations
    From the Services de chirurgie digestive, Hopital Henri-Mondor, Créteil, France

    From the Hopital Sainte Marguerite, Marseille Cedex, France
    Search for articles by this author
  • Bernard Sastre
    Affiliations
    From the Services de chirurgie digestive, Hopital Henri-Mondor, Créteil, France

    From the Hopital Sainte Marguerite, Marseille Cedex, France
    Search for articles by this author
  • Pierre-Louis Fagniez
    Affiliations
    From the Services de chirurgie digestive, Hopital Henri-Mondor, Créteil, France

    From the Hopital Sainte Marguerite, Marseille Cedex, France
    Search for articles by this author
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      Abstract

      Background. The surgical treatment of benign tumors of the pancreas usually consists of enucleation or formal pancreatectomy. Nonetheless, enucleation is not always feasible, and extended pancreatectomies may result in impaired endocrine and exocrine function.
      Methods. For these reasons we proposed a limited resection centered on the neck of the pancreas with complete excision of the tumor. The cephalic section was sutured, and a Roux-en-Y jejunal loop was anastomosed to the distal section of the pancreas. Fourteen patients were operated on by this technique. The tumors were mainly cystadenomas (n = 6) and endocrine tumors (n = 4). The other lesions were one epithelial cyst, one necrotic pseudocyst, one Castleman disease, and one cystadenocarcinoma diagnosed after surgery on histologic examination.
      Results. No patients died. Two patients underwent reoperation: one for a postoperative acute pancreatitis and one for a pancreatic fistula. All patients were followed up from 4 months to 8 years. No patients had exocrine insufficiency or diabetes mellitus.
      Conclusions. Medial pancreatectomy does not carry a higher operative risk than formal pancreatectomy and avoids extensive pancreatic resection when enucleation is not feasible.
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