Medial pancreatectomy for tumors of the neck of the pancreas.
Medial pancreatectomy for tumors of the neck of the pancreas.
复制标题
内侧胰腺切除术治疗胰腺颈部肿瘤。
作者：
N. Rotman;B. Sastre;P. Fagniez
背景
胰腺良性肿瘤的外科治疗通常包括摘除胰腺或正规的胰腺切除术。然而，眼球摘除并不总是可行的，延长的胰腺切除术可能会导致内分泌和外分泌功能受损。
方法
由于这些原因，我们建议以胰腺颈部为中心的有限切除，并完全切除肿瘤。缝合头部，并将Roux-en-Y空肠环与胰腺远端吻合。应用该技术对14例患者进行了手术治疗。肿瘤主要为囊腺瘤(6例)和内分泌肿瘤(4例)。其他病变包括上皮性囊肿1例，坏死性假性囊肿1例，Castleman病1例，囊腺癌1例。
结果
无患者死亡。两位患者接受了再次手术：一位是因为术后急性胰腺炎，一位是因为胰瘘。所有患者均获得4个月至8年的随访。无一例发生外分泌功能障碍或糖尿病。
结论
内侧胰腺切除术并不比正规胰腺切除术具有更高的手术风险，并且在不可行的情况下避免了广泛的胰腺切除术。
BACKGROUND
The surgical treatment of benign tumors of the pancreas usually consists of enucleation or formal pancreatectomy. Nonetheless, enucleation is not always feasible, and extended pancreatectomies may result in impaired endocrine and exocrine function.
METHODS
For these reasons we proposed a limited resection centered on the neck of the pancreas with complete excision of the tumor. The cephalic section was sutured, and a Roux-en-Y jejunal loop was anastomosed to the distal section of the pancreas. Fourteen patients were operated on by this technique. The tumors were mainly cystadenomas (n = 6) and endocrine tumors (n = 4). The other lesions were one epithelial cyst, one necrotic pseudocyst, one Castleman disease, and one cystadenocarcinoma diagnosed after surgery on histologic examination.
RESULTS
No patients died. Two patients underwent reoperation: one for a postoperative acute pancreatitis and one for a pancreatic fistula. All patients were followed up from 4 months to 8 years. No patients had exocrine insufficiency or diabetes mellitus.
CONCLUSIONS
Medial pancreatectomy does not carry a higher operative risk than formal pancreatectomy and avoids extensive pancreatic resection when enucleation is not feasible.