Residual total pancreatectomy: Short- and long-term outcomes |
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| Affiliation: | 1. Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto City, Japan;2. Institute of Resource Development and Analysis, Kumamoto University Graduate School of Medical Sciences, Kumamoto City, Japan;3. Department of Surgery, Kumamoto Regional Medical Center, Kumamoto City, Japan;1. Toxicology Laboratory, Doping Control Center, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea;2. Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea;3. Department of Biological Chemistry, Korea University of Science and Technology, Daejeon 34113, Republic of Korea;1. Institute of Resource Development and Analysis, Kumamoto University, 2-2-1 Honjo, Chuo-ku, Kumamoto 860-0811, Japan;2. Department of Cell Biology and Neuroscience, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;3. Department of Morphological Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan;1. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwa-no-ha, Kashiwa, Chiba 277-8577, Japan;2. Department of Radiology, National Cancer Center Hospital East, 6-5-1, Kashiwa-no-ha, Kashiwa, Chiba 277-8577, Japan;1. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan;2. Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;3. Division of Gastroenterological Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan;4. Department of Surgery, Nara Medical University, Nara, Japan;5. Department of Surgery, Kansai Medical University, Hirakata, Japan;6. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;7. Department of Surgery, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan;1. Trinity College Institute of Neuroscience & School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland;2. Trinity Biomedical Sciences Institute, School of Biochemistry and Immunology & School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland;1. General Surgery and Transplant Unit, Department of Medicine and Surgery, Sant''Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;2. General Surgery and Pancreatic Surgery Unit, Department of Surgery, GB Rossi Hospital, University of Verona, Verona, Italy;3. Division of Surgery A, Department of Surgery, GB Rossi Hospital, University of Verona, Verona, Italy;4. Department of Pathology, GB Rossi Hospital, University of Verona, Verona, Italy;5. Department of Haematology and Oncologic Sciences, Sant’Orsola-Malpighi Hospital, Univeristy of Bologna, Bologna, Italy |
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| Abstract: | Background/objectivesBecause of limited numbers of patients, there are limited data available regarding outcomes after residual total pancreatectomy (R-TP). This study aimed to assess outcomes after the R-TP vs the one-stage total pancreatectomy (O-TP), especially focused on the pancreatic adenocarcinoma cases.MethodsFrom 2005 to 2014, all patients who underwent the R-TP (n = 8) and the O-TP (n = 12) for pancreatic primary malignancy were prospectively enrolled.ResultsThe median time from the initial operation to the R-TP was 30 months. Ten patients in the O-TP group and 8 in the R-TP had pancreatic adenocarcinoma. Postoperative complications occurred in two O-TP patients and one R-TP patient. There was no in-hospital mortality. At 12 months after surgery, the median insulin dose was 27 U/day after the O-TP and 24 U/day after the R-TP, the median hemoglobin A1c was 7.2% after the O-TP and 6.9% after the R-TP. There was a significantly larger reduction in body weight after the O-TP than after the R-TP. Postoperative fatty liver disease occurred in about half of the patients in each group. In patients with pancreatic adenocarcinoma, the 2-year overall survival rate was not significantly different (68.6% after the O-TP vs 71.4% after the R-TP).ConclusionsAlthough the postoperative morbidity and nutritional statuses should be improved, these favorable short- and long-term outcomes demonstrate that the R-TP is a feasible procedure for patients with malignant tumor in the remnant pancreas. |
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| Keywords: | Residual total pancreatectomy Operation Complication Pancreatic adenocarcinoma Diabetes Total pancreatectomy |
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