Which is less invasive--distal pancreatectomy or segmental resection?

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pancreatic Surgery

Background:

• Distal pancreatectomy (DP) is standard for pancreatic body tumors.
• Segmental resection (SR) offers a less invasive alternative, prioritizing pancreatic function and quality of life.
• This study compares surgical stress and pancreatic function between DP and SR.

Purpose of the Study:

• To compare surgical stress, exocrine, and endocrine pancreatic functions between distal pancreatectomy (DP) and segmental resection (SR).
• To evaluate the impact of these surgical approaches on postoperative recovery and complications.

Main Methods:

• Compared 47 patients undergoing DP with 10 patients undergoing SR for benign pancreatic diseases.
• Assessed clinical findings including C-reactive protein (CRP), blood glucose, oral glucose tolerance tests, and pancreatic exocrine function tests.

Main Results:

• SR had longer operation times (356 min vs. 272 min) and hospital stays (65 days vs. 33 days) than DP.
• Pancreatic fistula incidence was higher in SR (40%) compared to DP (9%).
• SR preserved pancreatic endocrine and exocrine functions, while DP showed short-term glucose tolerance deterioration in some patients.

Conclusions:

• Segmental resection (SR) is superior to distal pancreatectomy (DP) in preserving pancreatic function.
• SR is associated with increased operative time, longer hospital stay, and a higher incidence of postoperative complications.
• The choice between SR and DP should consider the trade-off between functional preservation and surgical risks.