Clinical efficacy of middle pancreatectomy contrasts distal pancreatectomy: a single‐institution experience and review of literature

Abstract

Background We aim to analyse the difference of clinical efficacy between middle pancreatectomy (MP) and distal pancreatectomy (DP). Methods A retrospective study was used to analyse 39 cases of MP and 52 cases of DP from the Department of Hepatopancreatobiliary Surgery of the Affiliated Hospital of Qingdao University from February 2007 to December 2016. Furthermore, we identify randomized controlled trials or strictly designed clinical controlled trials on MP and DP. We performed a meta‐analysis of the final included studies using RevMan 5.3 software to illustrate the differences in efficacy between MP and DP. Results In the MP group, the operation time and diet start time were significantly longer than DP group. However, there was no significant difference in serious complications including clinically significant pancreatic fistula (grades B and C), delayed gastric emptying, reoperative and mortality. Furthermore, compared with DP, patients in MP group could benefit from long‐term post‐operative exocrine and endocrine function. Finally, we performed a meta‐analysis including 14 studies with a total of 1104 patients and proved that the pancreatic fistula rate, endocrine and exocrine function were significantly different in the two groups. Conclusion The MP is a safe and feasible surgical method. It can well preserve the endocrine and exocrine function of pancreas and improve the life quality of patients.

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

“…The long-term changes in endocrine and exocrine functions and tumor recurrence were evaluated based on radiological, clinical, and laboratory assessments. Endocrine pancreatic insufficiency was diagnosed as new-onset diabetes [20][21][22]. Exocrine pancreatic insufficiency was defined as diarrhea and steatorrhea, which improved with pancreatic enzyme supplementation [21][22][23].…”

Extended middle pancreatectomy for a large pancreatic cystic neoplasm: a case report

“…Compared with other surgical options (subtotal pancreatectomy and PD), this confers the advantage of parenchymal preservation and consequent preservation of pancreatic exocrine and endocrine functions. 3 Pancreaticoduodenectomy has been associated with increased postoperative morbidity and mortality. Similarly, the inability to preserve the spleen in subtotal pancreatectomy has been associated with complications of thrombosis and susceptibility to infection.…”

Recent trends in organ‐preserving pancreatectomy: Its problems and clinical advantages compared with other standard pancreatectomies

“…The main purpose of CP is to preserve pancreatic endocrine function by preserving the pancreatic tail and to maintain patient quality of life. Our literature search for articles on the comparison between CP and DP identified several studies published since 2010 [14][15][16][17][18][19][20][21][22][23][24][25][26][27] that had compared postoperative endocrine function between CP and DP cases (Table 1). As shown in Table 1, most of the studies presented the results of single-center retrospective studies or meta-analyses aggregating those retrospective studies.…”