Single-branch resection of the pancreas

Abstract

The treatment of intraductal papillary mucinous tumors (IPMT) of the pancreas is still controversial. In this report we describe a single-branch resection of the pancreas (SBRP), which is a new method for the removal of branch-type IPMT of the head of the pancreas. A multilobular cystic lesion (50 x 40 mm) in the head of the pancreas was incidentally detected in an asymptomatic 40-year-old man who underwent a routine ultrasound examination. The tumor was carefully removed along the border of the cyst and the normal parenchyma, with complete preservation of the main pancreatic duct and the common bile duct. A pancreatic fistula developed during the postoperative period, but was well-controlled by endoscopic naso-pancreatic drainage. SBRP is a technically feasible procedure and this operation represents a minimally invasive alternative to any other segmental resection of the pancreas.

Experience of limited pancreatic head resection for management of branch duct intraductal papillary mucinous neoplasm in a single center

“…Lastly, minutely injured duct was repaired without stent insertion, without leakage after operation. Sata et al [9] experienced pancreatic leakages which were managed by the insertion of an endoscopic nasopancreatic drainage tube. In segmental pancreas resection, pancreatic leakage rates reach up to 40% [20][21][22] .…”

“…Thereafter, pancreatic duct preserving procedures were reported, such as inferior pancreatic head resection, and uncinate process resection [5,7,8] . More minimal pancreatic head resections were performed such as single branch resection of the pancreas, and ductal branch-oriented minimal pancreatectomy [9,10] . Pancreatic leakage is one of the most frustrating complications after limited pancreatic resection.…”

“…minimal pancreatectomy [7,10] were performed in six patients. Single-branch resection [9] was performed in three patients. Two of nine patients underwent additional distal pancreatectomy for pancreatic tail IPMN.…”

“…In recent years, some surgeons have advocated limited pancreatectomy for management of benign IPMN and regarding this the following procedures have been reported in several papers: inferior head resection of the pancreas [5] , partial pancreatic head resection [6] , uncinate process resection [7,8] , single branch resection of the pancreas [9] , and ductal branch oriented minimal pancreatectomy [10] . It had been expected that there would be advantages of minimal pancreatic parenchymal loss and prevention of functional insufficiency by performing limited pancreatectomy.…”

Inferior head resection of the pancreas for intraductal papillary mucinous neoplasms

“…Previous reports have suggested that patients with non‐invasive IPMN have a favorable prognosis after surgical resection . Thus, a variety of types of partial pancreatic resections have been advocated for treating these low‐grade malignant tumors . Takada [20] presented the procedure of ventral pancreatectomy.…”