Evaluation of central pancreatectomy and pancreatic enucleation as pancreatic resections--A comparison.
INTRODUCTION
For minor pancreatic resection such as enucleation (PE) and central pancreatectomy (CP) comparative data are rare. These techniques provide parenchyma-sparing alternatives to major resections (e.g. pancreaticoduodenectomy) for neuroendocrine tumors, cystic tumors or metastases. This study retrospectively compares the morbidity and mortality of both techniques, with special regard to the formation of postoperative pancreatic fistulas (POPF).


METHODS
Between December 1996 and November 2013 the postoperative events and clinical outcomes of 17 patients after pancreatic enucleation and 26 patients after central pancreatectomy were retrospectively analyzed from a prospectively collected database.


RESULTS
Perioperative mortality was 0% in both groups. There was no significant difference in the overall peri-operative morbidity (CP 80.8% vs. PE 82.4%). The major cause of the high morbidity was the formation of a POPF with 26.9% of the patients after CP and 35.3% after PE. Univariate analysis showed a BMI over 30 kg/m(2) in the CP group to be an independent risk factor. Additional minor complications, e.g. urinary tract infection, pleural effusion, etc. furthermore contributed to the perioperative morbidity.


CONCLUSION
PE and central CP are feasible techniques for selected patients, but the indications are limited. Morbidity after these resections is high with the major cause being the development of a POPF.
['Wolk|Steffen|S|', 'Distler|Marius|M|', 'Kersting|Stephan|S|', 'Weitz|Jürgen|J|', 'Saeger|Hans-Detlev|HD|', 'Grützmann|Robert|R|']
D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D018358:Neuroendocrine Tumors D010180:Pancreatectomy D010185:Pancreatic Fistula D010190:Pancreatic Neoplasms D010195:Pancreatitis D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome
Central pancreatectomy Pancreatic enucleation Pancreatic fistula Insulinoma Pancreatic surgery