Pankreassegmentresektion

Abstract

Benign and low malignant tumors of the middle pancreatic segment can be resected by extended pancreaticoduodenectomy or distal pancreatic resection. Both procedures involve unavoidably extensive loss of normal pancreatic parenchyma, leading to deteriorated endocrine and exocrine pancreatic function. Segmental pancreatic resection represents an organ-preserving surgical procedure. Normal pancreatic tissue can be preserved as only the tumor with a pancreatic segment is resected. Several reports confirm lower mortality and minimal risk of postoperative endocrine or exocrine insufficiency than with standard pancreatic resections. The indication should be limited exclusively to benign or low malignant pancreatic tumors, metastases from other tumors, and focal chronic pancreatitis, as this type of resection cannot be deemed oncologic. Segmental pancreatic resections are technically more demanding and therefore should be performed in experienced centers.

Surgical Approaches to Chronic Pancreatitis

“…Kutup and his team developed the longitudinal “V-shape excision” of the ventral pancreas in patients suffering from “small duct” pancreatitis (pancreatic duct diameter < 3 mm) [ 14 ]. In patients with a focal CP in the corpus of the pancreas, a middle segmental pancreatic resection has been developed as another organ-preserving operation [ 15 ]. Depending on pathology and location, other procedures include pancreatic left resection or total pancreatectomy [ 16 ].…”