The role of central pancreatectomy in pancreatic surgery: a systematic review and meta-analysis

Xiao, Weidong; Zhu, Jisheng; Peng, Long; Hong, Le Van; Sun, Gen; Li, Yong

doi:10.1016/j.hpb.2018.05.001

Cited by 72 publications

(61 citation statements)

References 51 publications

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“…Since then, an increasing number of cases have been reported. Some systematic reviews and meta-analyses [9][10][11] showed that CP could decrease the risk of exocrine failure and impairment of endocrine function than DP, although it was associated with a slightly higher postoperative morbidity.…”

Section: Introductionmentioning

confidence: 99%

Central pancreatectomy for early-stage pancreatic ductal adenocarcinoma: a single-center case–control study

Gao

Liu

Wang

et al. 2019

Langenbecks Arch Surg

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Purpose Central pancreatectomy (CP) has been applied for treating benign and low-grade malignant tumors in pancreatic neck, but studies regarding CP for pancreatic ductal adenocarcinoma (PDAC) are quite limited. We aimed to investigate the role of central pancreatectomy in the treatment of PDAC in the neck of the pancreas. Methods Patients who underwent CP at our hospital between 2009 and 2016 were identified. Patients treated by distal pancreatectomy (DP) were matched according to the tumor size, location, and staging. The surgical and survival outcomes were compared between the CP and DP groups. Results Nine patients had CP. Five (56%) had postoperative complications and three (33%) had clinically significant (grade B + C) fistula. No significant difference was found between the CP and DP groups for the rate of overall morbidity, pancreatic fistula, reoperation, and readmission. Tumor size was smaller in the CP group compared to the DP group. The mortality of both groups was zero. The median postoperative survival was similar between the two groups (20.4 months for CP vs 19.4 months for DP, P = 0.842). Conclusions CP is safe for patients with small PDAC at the neck of the pancreas. Considering the good preservation of pancreatic endocrine and exocrine functions, CP could be considered as an alternative procedure for single small PDAC in pancreatic neck.

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Section: Introductionmentioning

confidence: 99%

Central pancreatectomy for early-stage pancreatic ductal adenocarcinoma: a single-center case–control study

Gao

Liu

Wang

et al. 2019

Langenbecks Arch Surg

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“…Though CP has a higher risk of pancreatic fistula, it maintains pancreatic endocrine and exocrine function better than distal pancreatectomy and pancreaticoduodenectomy. Pancreas preserved operation provides better long-term outcomes 1 .…”

Section: Discussionmentioning

confidence: 99%

“…In 1982, Dagradi and Serio first reported CP with reconstruction of pancreas by oversewing the cephalic stump and performing an end-to-end pancreatojejunostomy for the distal pancreatic stump 2 . This procedure is considered safe and optimizes the quality of patients' life. Up to now, Dagradi and Serio' method is the conventional procedure in open and minimally invasive surgery [4][5][6] .But it has a higher risk of pancreatic fistula 1 . Various studies indicate that the use of pancreatojejunostomy may lead the high risk of pancreatic fistula [7][8] .…”

Section: Introductionmentioning

confidence: 99%

Central pancreatectomy combined with end-to-end anastomosis reconstruction versus conventional central pancreatectomy in robotic surgery: study protocol for a randomized clinical trial

Zhu

Zhang

et al. 2019

Preprint

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[EXSCINDED] Abstract Abstract Background Central pancreatectomy (CP) is an ideal surgery option for benign and low malignant potential lesions in the neck and body of pancreas. CP maintains pancreatic endocrine and exocrine function better than distal pancreatectomy and pancreaticoduodenectomy, but it has a higher risk of pancreatic fistula1. Up to now, CP reported by Dagradi and Serio2 is the standard procedure. But our four-year experience suggests CP with end-to-end anastomosis could reduce pancreatic fistula and other complication rates. The aim of the trial is to investigate whether the CP combined with end-to-end anastomosis reconstruction approach can reduce the fistula rate of patients with pancreatic neck and body benign and low malignant lesions compared with the conventional approach. We hypothesize that CP combined with end-to-end anastomosis could be an alternative procedure of conventional CP.Methods/design The trial is a single center, randomized controlled trial with two parallel research group. The trial compares the possible advantages of CP combined with end-to-end anastomosis to conventional CP in robotic surgery. One hundred and seventy patients with pancreatic neck and body benign and low malignant lesions in Chinese People’s Liberation Army (PLA) General Hospital will be enrolled. The patients will be divided into two groups randomly. One group will choose CP with end-to-end anastomosis while the other group will use conventional CP. The primary endpoint will be postoperative pancreatic fistula (POPF) rate.Discussion There is no randomized clinical trial to estimate the advantages of CP with end-to-end anastomosis reconstruction. The CP with end-to-end anastomosis reconstruction in robotic surgery was first reported by Professor Liu in our department, and professional surgical techniques can reduce confounding factors and have high recruitment rate. For our research is a randomized clinical trial, we can provide high quality evidence on CP standard.

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“…In the past, it was believed that pancreatectomy had high mortality and morbidity rates; however, recent clinical analyses of large sample sets have revealed that a pancreatectomy has low mortality rates and acceptable morbidity rates, and the operation for pancreas metastases is safe [ 17 , 21 , 27 ]. Xiao et al [ 28 ] reported that medial pancreatectomy maintains pancreatic endocrine and exocrine function better than other standardized pancreatic resections, which is suitable for benign or low grade malignant lesions. In previous literatures, the perioperative mortality rate has been reported as being 1–3% [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Solitary pancreatic metastasis of extremity myxoid liposarcoma: a case report and literature review

Wang

et al. 2018

BMC Cancer

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BackgroundMyxoid liposarcoma has a distinct migration aptitude; however, pancreatic metastasis is rare.Case presentationWe report on the case of a 40-year-old female patient who suffered solitary pancreatic metastasis of myxoid liposarcoma and had a right thigh myxoid liposarcoma radical resection 5 years ago. The patient underwent a medial pancreatectomy and pancreaticojejunostomy for solitary pancreatic metastasis of myxoid liposarcoma. After 12 months of disease-free survival, the patient underwent an extended radical resection for the recurrence of the right thigh primary myxoid liposarcoma and received postoperative radiotherapy. Currently, the disease-free survival time after the last operation has been 22 months.ConclusionsWe reviewed the relevant literature and suggest that radical surgery might result in a good prognosis for patients with solitary pancreatic metastasis of myxoid liposarcoma.

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The role of central pancreatectomy in pancreatic surgery: a systematic review and meta-analysis

Abstract: CP maintains pancreatic endocrine and exocrine function better than DP and PD, but is associated with a higher PF rate.

Cited by 72 publications

References 51 publications

Central pancreatectomy for early-stage pancreatic ductal adenocarcinoma: a single-center case–control study

Central pancreatectomy for early-stage pancreatic ductal adenocarcinoma: a single-center case–control study

Central pancreatectomy combined with end-to-end anastomosis reconstruction versus conventional central pancreatectomy in robotic surgery: study protocol for a randomized clinical trial

Solitary pancreatic metastasis of extremity myxoid liposarcoma: a case report and literature review

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