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Journal of Gastrointestinal Surgery

, Volume 16, Issue 7, pp 1347–1353 | Cite as

Pancreatic Enucleation: Improved Outcomes Compared to Resection

  • C. E. Cauley
  • H. A. PittEmail author
  • K. M. Ziegler
  • A. Nakeeb
  • C. M. Schmidt
  • N. J. Zyromski
  • M. G. House
  • K. D. Lillemoe
Original Article

Abstract

Introduction

Pancreatic enucleation is associated with a low operative mortality and preserved pancreatic parenchyma. However, enucleation is an uncommon operation, and good comparative data with resection are lacking. Therefore, the aim of this analysis was to compare the outcomes of pancreatic enucleation and resection.

Material and Methods

From 1998 through 2010, 45 consecutive patients with small (mean, 2.3 cm) pancreatic lesions underwent enucleation. These patients were matched with 90 patients undergoing pancreatoduodenectomy (n = 38) or distal pancreatectomy (n = 52). Serious morbidity was defined in accordance with the American College of Surgeons–National Surgical Quality Improvement Program. Outcomes were compared with standard statistical analyses.

Results

Operative time was shorter (183 vs. 271 min, p < 0.01), and operative blood loss was significantly lower (160 vs. 691 ml, p < 0.01) with enucleation. Fewer patients undergoing enucleation required monitoring in an intensive care unit (20% vs. 41%, p < 0.02). Serious morbidity was less common among patients who underwent enucleation compared to those who had a resection (13% vs. 29%, p = 0.05). Pancreatic endocrine (4% vs. 17%, p = 0.05) and exocrine (2% vs. 17%, p < 0.05) insufficiency were less common with enucleation. Ten-year survival was no different between enucleation and resection.

Conclusion

Compared to resection, pancreatic enucleation is associated with improved operative as well as short- and long-term postoperative outcomes. For small benign and premalignant pancreatic lesions, enucleation should be considered the procedure of choice when technically appropriate.

Keywords

Cystic tumors Enucleation Neuroendocrine tumors Pancreatic resection 

Notes

Acknowledgments

Funding for this work was provided by the Indiana University Department of Surgery.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • C. E. Cauley
    • 1
  • H. A. Pitt
    • 1
    Email author
  • K. M. Ziegler
    • 1
  • A. Nakeeb
    • 1
  • C. M. Schmidt
    • 1
  • N. J. Zyromski
    • 1
  • M. G. House
    • 1
  • K. D. Lillemoe
    • 1
  1. 1.Department of SurgeryIndiana University School of MedicineIndianapolisUSA

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