Experiences in central pancreatectomy

Background: Non-cancerous pancreatic lesions have been increasing, and function-preserving pancreatectomy may be an adequate approach to them. Recent advanced experience of major pancreatectomy has stimulated interest in central pancreatectomy (CP). Materials and Methods: Nineteen patients who underwent CP for benign and borderline malignant lesions of the pancreas from January 1990 to December 2007 were retrospectively reviewed. We also summarized recent literature reporting more than 10 cases of CP. Result: Nine patients (47.4%) experienced postoperative complications. Pancreatic leak was noted in 7 patients (36.8%). Two patients (10.5%) required reoperation due to intractable pancreatic leak and postoperative bleeding. No mortality was noted. During the follow-up period (median 35 months, range 3-182 months), only 1 patient (5.3%) developed new-onset diabetes after successful CP. In a comparative study, similar perioperative morbidity was noted between CP and extended distal pancreatectomy with splenectomy (extended DP-S); however, the operation time and postoperative hospital stay were significantly longer in the CP group and the incidence of new-onset diabetes was much lower in the CP group as compared with the DP-S group (p < 0.05). Conclusion: CP can be carefully selected as an appropriate surgical option for benign and borderline malignant lesions limited to the pancreatic neck area.