Extended central pancreatic resection as an alternative for extended left or extended right resection for appropriate pancreatic neoplasms

Cataldegirmen, Guellue; Schneider, Claus; Bogoevski, Dean; Koenig, Alexandra M.; Kaifi, Jussuf T.; Bockhorn, Maximilian; Deutsch, Lena; Vashist, Yogesh K.; Izbicki, Jakob R.; Yekebas, Emre F.

doi:10.1016/j.surg.2009.10.027

Cited by 45 publications

(59 citation statements)

References 26 publications

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“…(86) The overall morbidity rates after CP, reported in large series in the literature, ranged from 26% to 75%, with a postoperative pancreatic fistula as the main complication (8% to 63% of the patients) (table 1). (6,7,9,10,16,17,19,(28)(29)(30) A recent meta-analysis has shown an overall morbidity rate of 46%, with a pancreatic fistula rate of 30% after CP. (2) A recent review has shown that despite high rates of pancreatic fistula after a CP, most of the patients can be conservatively managed.…”

Section: Early Results From Central Pancreatectomyhigh Morbidity Ratementioning

confidence: 99%

“…(2) The same findings were reported in large single center experiences with CP (table 1). (6,7,9,10,16,17,19,(28)(29)(30) A widely accepted indication for a CP is represented by a serous cystadenoma. (2) However, the feasibility of a parenchyma-sparing resection in a patient diagnosed with a serous cystadenoma should not change the surgical indications for this pathology, which usually has a surgical expectative approach.…”

Section: Indications and Contraindications For A Central Pancreatectomentioning

confidence: 99%

“…(53) Large published series have shown that the main indications for a CP were represented by the neuroendocrine tumors (8%-36%), serous cystadenomas (20%-44%), mucinous cystadenomas (8%-35%), and branch type intraductal papillary mucinous neoplasms (12%-35%) (table 1). (6,7,9,10,16,17,19,(28)(29)(30) In a recent meta-analysis, the main indications for a CP were reported to be the serous/mucinous cystadenomas (28%), followed by the neuroendocrine tumors (23%) and intraductal papillary mucinous neoplasms (18%). (2) Beyond the benign and low malignant potential pathology, CP has been reported in several special malignancies of the pancreas.…”

Section: Indications and Contraindications For A Central Pancreatectomentioning

confidence: 99%

“…(11)(12)(13)(14) Even in high-volume centers for pancreatic resections, favorable for a CP, the percentages for this surgical procedure were reported to be less than 5.5% of all pancreatic resections. (8,9,(15)(16)(17)(18)(19) Beside a "central pancreatectomy", with the same significance were used the following terms: "median/ medial/middle/ intermediate pancreatectomy", "mesopancreatectomy" or "segmental pancreatectomy". (4,20,21) The aim of the present paper was to provide an upto-date review of the indications, technical issues, and early and late outcomes after CP, based on the relevant literature.…”

Section: Introduction Introductionmentioning

confidence: 99%

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Central pancreatectomy revisited

Dumitraşcu¹,

Popescu²

2015

JTMR

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Central pancreatectomy (CP) is a parenchyma-sparing alternative resection to distal pancreatectomy, for benign and low malignant potential tumors located on the pancreatic isthmus and/ or body. Pancreatic metastases of other neoplasia might also benefit after a CP, in selected patients. Dagradi and Serio described the modern technique of CP, while Iacono introduced it in current clinical practice. An open CP represents the standard, but there is an emerging role for the minimally-invasive approach, which might become a standard for CP in experienced centers, particularly for the robotic approach. The rationale of a CP was to preserve the postoperative pancreatic functions because it implies the loss of a minimal amount of normal pancreatic tissue. However, the real clinical benefit of a CP is still controversial. High overall morbidity and pancreatic fistula rates were reported after a CP. However, most of the complications after a CP have been conservatively managed, with almost zero mortality. A CP has a minimal impact on the postoperative pancreatic functions; the diabetes mellitus rate after a CP is significantly lower, compared with the distal pancreatectomies. A proper selection of candidates for a CP is recommended. Thus, tumors located on the pancreatic isthmus are more likely to benefit after a CP, because the alternative surgical technique in these patients is an extended left pancreatectomy, a procedure with increased risk of postoperative pancreatic insufficiencies. Individual patient-related factors should be taken into consideration in the selection of the patients. Thus, a CP should be used in young patients, non-obese and without diabetes mellitus, with a good biological status, which might be able to overcome the potential postoperative complications. A CP can be safely incorporated into an experienced pancreatic surgeon armamentarium, albeit it represents an uncommon pancreatic resection. Abbreviations: Central pancreatectomy (CP); Physiologic and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM).

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Section: Early Results From Central Pancreatectomyhigh Morbidity Ratementioning

confidence: 99%

Section: Indications and Contraindications For A Central Pancreatectomentioning

confidence: 99%

Section: Indications and Contraindications For A Central Pancreatectomentioning

confidence: 99%

Section: Introduction Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Central pancreatectomy revisited

Dumitraşcu¹,

Popescu²

2015

JTMR

View full text Add to dashboard Cite

show abstract

“…Bei diesen Patienten führt eine Drainageoperation kaum zu einer Verbesserung der klinischen Symptomatik, und resezierende Verfahren sind vorzuziehen. [412]. Da bei der Segmentresektion vergleichsweise deutlich weniger funktionsfähiges Pankreasparenchym entfernt wird, ist ein postoperativer Diabetes mellitus oder eine exokrine Pankreasinsuffizienz seltener [413 -419].…”

Section: Leitlinie 1187unclassified