Skip to main content

Advertisement

SpringerLink
Log in

Elective pancreatic reresection – report of a series and review of the literature

Elektive Reresektion des Pankreas – Präsentation einer Fallserie und der aktuellen Literatur

  • Original Scientific Paper
  • Published:
European Surgery Aims and scope Submit manuscript

Zusammenfassung

GRUNDLAGEN: Es gibt kaum Daten zu klinischer Relevanz, Indikation, Patientenselektion, Inzidenz, perioperativer Morbidität und möglichem Nutzen der Reresektion des Pankreas. Wir wollen unsere Erfahrung und einen Überblick über die aktuelle Literatur präsentieren. METHODIK: Es wird der klinische Verlauf von 3 Patienten präsentiert und anhand einer Pubmed-Suche die aktuelle Literatur vorgestellt. ERGEBNISSE: In den Jahren 2001 bis 2008 wurden an unserer Abteilung 189 Pankreas-Resektionen durchgeführt. Bei 3 (1,6 %) Patienten wurde eine elektive Reresektion durchgeführt. Alle Reresektionen wurden 2008 durchgeführt, in diesem Jahr lag der Anteil bei 7,3 % (3/41). Abgesehen von einzelnen Fallpräsentationen ergab unsere Literatursuche lediglich 4 kleine Serien die die Ergebnisse von 3 bis 15 Patienten zusammenfassen. SCHLUSSFOLGERUNGEN: Die elektive Reresektion des Pankreas ist eine sinnvolle und sichere Operation. Derzeit scheinen das Wiederauftreten einer IPMN oder einer chronischen Pankreatitis die vielversprechensten Indikationen zu sein.

Summary

BACKGROUND: Pancreatic reresection is an absolute rarity in surgical practice and literature, this induced us to report our experience and present a review of the literature. METHODS: Three patients underwent pancreatic reresection at our department. A review of the literature on elective pancreatic reresection was done by a PubMed search. RESULTS: From 2001 to 2008, 189 pancreatic resections due to various indications were performed. In three (1.6%) patients an elective reresection was performed. For 2008, when all reresections were carried out, the percentage of reresection was 7.3% (3/41). Apart from a few single case reports the literature search identified only four small series summarizing the results of 3–15 patients undergoing elective pancreatic reresection. CONCLUSIONS: Elective pancreatic reresection is a feasible and safe procedure. Today, recurrence of IPMN and failure of previous surgical therapy in chronic pancreatitis seem to be the most promising indications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • McPhee JT, Hill JS, Whalen GF, Zayaruzny M, Litwin DE, Sullivan ME, et al. Perioperative mortality for pancreatectomy: a national perspective. Ann Surg 2007;246:246–53

    Article  PubMed  Google Scholar 

  • Winter JM, Cameron JL, Campbell KA, Arnold MA, Chang DC, Coleman J, et al. 1423 pancreatoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg 2006;10:1199–210

    Article  PubMed  Google Scholar 

  • Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, et al. Hospital volume and surgical mortality in the United States. N Engl J Med 2002;346:1128–37

    Article  PubMed  Google Scholar 

  • Grobmyer SR, Pieracci FM, Allen PJ, Brennan MF, Jaques DP. Defining morbidity after pancreatoduodenectomy: use of a prospective complication grading system. J Am Coll Surg 2007;2004:356–64

    Article  Google Scholar 

  • Traverso LW, Shinichi H, Low DE. Useful benchmarks to evaluate outcomes after esophagectomy and pancreatoduodenectomy. Am J Surg 2004;187:604–8

    Article  PubMed  Google Scholar 

  • Kleeff J, Reiser C, Hinz U, Bachmann J, Debus J, Jaeger D, et al. Surgery for recurrent pancreatic ductal adenocarcinoma. Ann Surg 2007;245:566–72

    Article  PubMed  Google Scholar 

  • Miura F, Takada T, Amano H, Yoshida M, Isaka T, Toyota N, et al. Repeated pancreatectomy after pancreatoduodenectomy. J Gastrointest Surg 2007;11:179–86

    Article  PubMed  Google Scholar 

  • Seelig MH, Chromik A, Weyhe D, Müller Ch, Belyaev O, Mittelkötter U, et al. Pancreatic redo procedures: to do or not to do – this is the question. J Gastrointest Surg 2007;11:1175–82

    Article  PubMed  Google Scholar 

  • White R, D'Angelica M, Katabi N, Tang L, Klimstra D, Fong Y, et al. Fate of the remnant pancreas after resection of noninvasive intraductal papillary mucinous neoplasm. J Am Coll Surg 2007;204:987–95

    Article  PubMed  Google Scholar 

  • Dalla Valle R, Mancini C, Crafa P, Passalacqua R. Pancreatic carcinoma recurrence in the remnant pancreas after a pancreaticoduodenectomy. J Pancreas 2006;7(5):473–7

    Google Scholar 

  • D'Amato A, Gentili V, Santella S, Boschetto A, Pronio A, Montesani C. Carcinoma of the pancreatic remnant developing after pancreatoduodenectomy for adenocarcinoma of the head of the pancreas. Chir Ital 2002;54:539–44

    PubMed  Google Scholar 

  • Eriguchi N, Aoyagi S, Imayama H, Okuda K, Hara M, Fukuda S, et al. Resectable carcinoma of the pancreatic head developing 7 years and 4 months after distal pancreatectomy for carcinoma of the pancreatic tail. J Hepatobiliary Pancreat Surg 2000;7:316–20

    Article  CAS  PubMed  Google Scholar 

  • Inoue K, Kosuge T, Shimada K, Yamamoto J, Takayama T, Ozaki H, et al. Repeated radical resection and intraoperative irradiation for recurrent pancreatic ductal adenocarcinoma after pancreatoduodenectomy. Surgery 1995;118:909–11

    Article  CAS  PubMed  Google Scholar 

  • Takamatsu S, Ban D, Irie T, Noguchi N, Kudoh A, Nakamura N, et al. Resection of a cancer developing in the remnant pancreas after a pancreaticoduodenectomy for pancreas head cancer. J Gastrointest Surg 2005;9:263–9

    Article  PubMed  Google Scholar 

  • Wada K, Takada T, Yasuda H, Amano H, Yoshida M. A repeated pancreatectomy in the remnant pancreas 22 months after pylorus-preserving pancreatoduodenectomy for pancreatic adenocarcinoma. J Hepatobiliary Pancreat Surg 2001;8:174–8

    Article  CAS  PubMed  Google Scholar 

  • Bassi C, Sarr MG, Lillemoe KD, Reber HA. Natural history of intraductal papillary mucinous neoplasms (IPMN): current evidence and implications for management. J Gastrintest Surg 2008;12:645–50

    Article  Google Scholar 

  • Seelig MH, Janot M, Chromik A, Herzog T, Belayev O, Weyhe D, et al. Redo-surgery following curative resection of pancreatic carcinoma: the difference between true and suspected recurrence. Dig Surg 2009;26:222–8

    Article  PubMed  Google Scholar 

  • Sperti C, Pasquali C, Piccoli A, Pedrazzoli S. Recurrence after resection for ductal adenocarcinoma of the pancreas. World J Surg 1997;21:195–200

    Article  CAS  PubMed  Google Scholar 

  • Keck T, Hopt UT. Totale Pankreatektomie: Renaissance eines Operationsverfahrens. Chirurg 2008;79:1134–40

    Article  CAS  PubMed  Google Scholar 

  • Farnell MB. Surgical management of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. J Gastrointest Surg 2008;12:414–6

    Article  PubMed  Google Scholar 

  • Dite P, Ruzicka M, Zboril V, Novotny I. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy 2003;35:553–8

    Article  CAS  PubMed  Google Scholar 

  • Keck T, Marjanovic G, Fernandez-del Castillo C, Makowiec F, Schäfer AO, Rodriguez JR. The inflammatory pancreatic head mass: significant differences in the anatomic pathology of German and American patients with chronic pancreatitis determine very different surgical strategies. Ann Surg 2009;249:105–10

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Hospital Elisabethinen, Linz, Austria

    O. Gangl, U. Fröschl & R. Függer

  2. Medical University of Vienna, Vienna, Austria

    B. Dutta-Függer

Authors
  1. O. Gangl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Fröschl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Dutta-Függer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Függer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O. Gangl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gangl, O., Fröschl, U., Dutta-Függer, B. et al. Elective pancreatic reresection – report of a series and review of the literature. Eur Surg 42, 91–95 (2010). https://doi.org/10.1007/s10353-010-0527-0

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-010-0527-0

Schlüsselwörter

Keywords

Search

Navigation