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Updated: Jun 14, 2025
Application of Mid-Pancreatectomy with End-to-End Anastomosis in Pancreatic Benign Tumors
Published on: February 9, 2024
Comparative outcomes of parenchyma-sparing repeat pancreatectomy vs completion pancreatectomy: impact on endocrine
Ryoji Furuya1, Yoshinori Takeda1, Atsushi Takahashi1
1Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, Hongo, Tokyo, Japan.
Background:
Although completion pancreatectomy (CP) is the standard approach for repeat pancreatectomy of secondary pancreatic tumors, the incidence of postoperative endocrine insufficiency is high. Parenchyma-sparing repeat pancreatectomy (PSRP) can preserve this function. However, its feasibility and long-term outcomes have not been evaluated. This study compared short-term outcomes and long-term endocrine pancreatic function between PSRP and CP.
Methods:
Consecutive patients who underwent a second pancreatectomy between April 2005 and March 2024 at 2 high-volume centers were included. This study compared the short- and long-term outcomes between the PSRP and CP groups. Serum hemoglobin A1c (HbA1c) levels 6 months after surgery and the occurrence of hypoglycemic episodes were evaluated as indicators of endocrine function.
Results:
A total of 30 patients (11 in the PSRP group and 19 in the CP group) were included. The 2 groups showed no significant differences in the preoperative or intraoperative findings. None of the patients in the PSRP group experienced major morbidity (Clavien-Dindo grade of ≥III), whereas 4 patients (21%) in the CP group experienced major morbidity. HbA1c levels and the requirement for insulin therapy were significantly lower in the PSRP group than in the CP group (6.2% vs 7.6% [P <.001] and 27.0% vs 100.0% [P <.001], respectively). Hypoglycemic episodes were observed only in the CP group (4 patients).
Conclusion:
PSRP might have favorable short-term outcomes and better long-term endocrine function than CP.
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