Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

Comparative Analysis of Limited Resection and Conventional Resection for Pancreatic Benign Lesions Focused on Perioperative Diabetes and Pancreatic Fistula

제한적 절제술과 근치적 절제술 후의 췌장루와 당뇨 발생에 대한 비교분석

  • Choi, Min-Young (Department of Surger, Samsung Medical Center, Sungkyunkwan University) ;
  • You, Dong-Do (Department of Surger, Samsung Medical Center, Sungkyunkwan University) ;
  • Lee, Hyung-Geun (Department of Surger, Samsung Medical Center, Sungkyunkwan University) ;
  • Heo, Jin-Seok (Department of Surger, Samsung Medical Center, Sungkyunkwan University) ;
  • Choi, Seong-Ho (Department of Surger, Samsung Medical Center, Sungkyunkwan University) ;
  • Choi, Dong-Wook (Department of Surger, Samsung Medical Center, Sungkyunkwan University)
  • 최민영 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 유동도 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 이형근 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 허진석 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 최성호 (성균관대학교 의과대학 삼성서울병원 외과) ;
  • 최동욱 (성균관대학교 의과대학 삼성서울병원 외과)
  • Published : 2009.09.30

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Abstract

Purpose: Pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) are treatments used for pancreatic benign neoplasms even though both of these treatments result in significant loss of normal pancreatic parenchyma; this leads to subsequent impairment of exocrine and endocrine pancreatic function. The purpose of this study is to provide short-and long-term result of limited resection (LR) in a single center. Methods: Two-hundred thirty patients who had undergone pancreatic resection between April1998 and September 2008 for benign neoplasms were reviewed retrospectively. DP was performed in 102 patients, LR in 77, PD in 51 patients. The definitions of the International Study Group of Pancreatic Fistula (ISGPF) were applied to postoperative pancreatic fistulas (POPF), perioperative endocrine function was evaluated through oral glucose tolerance test. Results: LR includes 42 enucleation, 24 central pancreatectomy, and 11 uncinate process resection. No deaths occurred to patients during the study review period; POPF was detected in 50 patients (65%), 37 patients with grade A and 13 patients with grade B or C. POPF occurred 65% of the time after LR, more frequently compared to the occurrance after PD or DP (58%), but this was not statistically significant (P =.322). After LR, there were 2 patients with new onset diabetes (3%), while 26 (17%) patients developed diabetes after DP or PD (P = .002). Conclusion: LR may preserve endocrine and exocrine function. While mortality is low with the use of LR, it is associated with a higher pancreatic-leakage rate. The precise management of benign pancreatic lesions remains in evolution.

Keywords

References

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