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Central pancreatectomy revisited

  • Original Articles
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Journal of Gastrointestinal Surgery

Abstract

Central pancreatectomy is a surgical procedure that removes the middle segment of the pancreas and preserves the distal pancreas and spleen. This limited resection has the advantage of conserving normal, uninvolved pancreatic parenchyma, thus reducing the possibility of postoperative exocrine and endocrine dysfunction. While the incidence of postoperative endocrine insufficiency may be as low as 4%, procedural morbidity, specifically pancreatic fistula, appears to exceed the published rates for standard resections (i.e., distal/subtotal pancreatectomy or pancreaticoduodenectomy). We have reviewed our prospective pancreatic cancer database to determine the utilization of central pancreatectomy in a major cancer center with expertise in pancreatic surgery. We identified only 10 cases of central pancreatectomy over the past 13 years. Six (60%) had postoperative complications including three cases (30%) of pancreatic fistula. No patients died as a result of the procedure. At a median follow-up of 13.6 months (mean, 25.2 months), only one patient had mild endocrine insufficiency and no patients had clinically significant exocrine dysfunction. The associated morbidity of central pancreatectomy may outweigh any potential benefit in long-term pancreatic secretory function. We suggest that such a procedure be used selectively, where preservation of the pancreas appears essential.

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Authors and Affiliations

  1. From the Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York

    Kevin K. Roggin M.D., Leslie H. Blumgart M.D. & Murray F. Brennan M.D.

  2. the Department of Surgery, New York University Hospitals, New York, New York

    Udo Rudloff M.D.

  3. the Department of Surgery, University of Chicago, Chicago, Illinois

    Kevin K. Roggin M.D.

Authors
  1. Kevin K. Roggin M.D.
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  2. Udo Rudloff M.D.
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  3. Leslie H. Blumgart M.D.
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  4. Murray F. Brennan M.D.
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Correspondence to Murray F. Brennan M.D..

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Roggin, K.K., Rudloff, U., Blumgart, L.H. et al. Central pancreatectomy revisited. J Gastrointest Surg 10, 804–812 (2006). https://doi.org/10.1016/j.gassur.2005.11.012

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