Comparison of central and extended left pancreatectomy for lesions of the pancreatic neck.
Publication/Presentation Date
8-1-2008
Abstract
BACKGROUND: Central pancreatectomy (CP) is a parenchyma-sparing alternative to extended left pancreatectomy (ELP) for tumors of the pancreatic neck. We compared short- and long-term outcomes for the two approaches.
METHODS: Patients who underwent CP or ELP from 2000-2007 for neoplasms of the neck were identified. Charts were reviewed for patient, treatment, and outcome data. Long-term and quality-of-life (QoL) data were gathered through Institutional Review Board (IRB)-approved telephone interviews and questionnaires European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and QLQ-PAN26.
RESULTS: 31 patients were identified; 13 underwent CP and 18 underwent ELP. Median follow-up was 29 months (range 5-90). Groups did not differ in age, American Society of Anesthesiologists (ASA) class, or preexisting diabetes mellitus (DM). CP patients had less gland resected (5.7 +/- 2.1 cm versus 10.8 +/- 2.8 cm) and lower postoperative mean blood glucose levels (120 +/- 15 mg/dl versus 136 +/- 24 mg/dl). CP patients experienced more complications (92% versus 39%), but no significant difference in major complications (38%, CP versus 17%, ELP; P = 0.17) or hospital stay (9 +/- 3 days, CP versus 7.5 +/- 4 days, ELP). There was one perioperative death in the CP group, unrelated to surgical technique. Questionnaire analysis showed no differences in functional or symptom scales. New-onset exocrine insufficiency was not significantly different between the groups (10%, CP versus 27%, ELP; P = 0.62), but the ELP group had a higher rate of new-onset DM (57% versus 11%; P = 0.04).
CONCLUSION: CP is associated with more complications than ELP, but no difference in long-term QoL. Due to the lower incidence of postoperative DM, CP can be recommended for healthy patients with indolent tumors of the pancreatic neck.
Volume
15
Issue
8
First Page
2096
Last Page
2103
ISSN
1534-4681
Published In/Presented At
Ocuin, L. M., Sarmiento, J. M., Staley, C. A., Galloway, J. R., Johnson, C. D., Wood, W. C., & Kooby, D. A. (2008). Comparison of central and extended left pancreatectomy for lesions of the pancreatic neck. Annals of surgical oncology, 15(8), 2096–2103. https://doi.org/10.1245/s10434-008-9987-x
Disciplines
Medicine and Health Sciences
PubMedID
18521682
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article