Middle-preserving pancreatectomy for multicentric body-sparing lesions of the pancreas

Background

The appropriate surgical approach of a pancreatic multifocal disease that skips the body of the gland remains unknown. We sought to analyze a parenchyma-sparing surgical technique consisting of a middle-preserving pancreatectomy (MPP) evaluating feasibility, safety, and oncological and functional outcomes.

Patients and methods

Between 1999 and 2007, 5 patients affected by pancreatic benign or slow malignant multicentric body-sparing disease underwent MPP.

Results

There were 3 men and 2 women with a median age of 35 years (range 28-70 years). The median operative time was 365 minutes (range 330-440 minutes). Postoperative mortality was nil and postoperative morbidity was 1 (20%). At a median follow-up of 20 months (range 14-118 months) all of the patients are alive and disease-free. Overall, 2 patients developed insulin-dependent diabetes mellitus, as well as exocrine insufficiency. One patient developed only exocrine insufficiency.

Conclusions

MPP is a feasible procedure and might reduce the risk of both endocrine and exocrine insufficiency.