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Middle segment pancreatectomy: a novel technique for conserving pancreatic tissue
A L Warshaw1, D W Rattner, C Fernández-del Castillo
1Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|March 28, 1998
Summary
Middle segment pancreatectomy offers a tissue-sparing approach for pancreatic tumors. This technique effectively resects tumors in the pancreatic neck and body, preserving endocrine and exocrine function and the spleen.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Pancreatic Surgery
Background:
- Standard resections for pancreatic neck/body tumors risk diabetes and spleen loss.
- Limited tissue resection is desirable for benign pancreatic neoplasms.
Purpose of the Study:
- To describe the middle segment pancreatectomy technique.
- To evaluate its safety and efficacy in resecting pancreatic neck and body tumors.
Main Methods:
- Middle segment pancreatectomy performed on 12 patients with pancreatic neck/body tumors.
- Roux-en-Y jejunal loop reconstruction with duct stenting and drainage.
- Tumor resection with clear margins.
Main Results:
- Successfully resected 12 tumors (0.9-5.2 cm) including cystic neoplasms, islet cell tumors, and intraductal papillary mucinous tumors.
- No patients developed diabetes or required enzyme supplements.
- Low morbidity: 2 temporary pancreatic fistulas, 1 delayed gastric emptying. Median stay: 8 days.
- Mean follow-up of 18 months with no local recurrences.
Conclusions:
- Middle segment pancreatectomy is a safe and effective organ-preserving surgical option.
- It successfully resects selected pancreatic tumors while maintaining pancreatic function and spleen viability.