The conventional operations for benign and borderline pancreatic tumors are distal pancreatectomy and enucleation.
In this study, a team of investigators from Italy performed an analysis of prospectively collected data from 67 patients with nonmalignant neoplasms of the pancreatic body.
Of the 67 operations, 32 were median pancreatectomies, 21 distal pancreatectomies, and 14 enucleations.
|Pancreatic fistula rate = 50% after median pancreatectomy.|
The team compared both the operative and long-term outcomes.
They determined that enucleation had a shorter operative time, and patients experienced less blood loss, than the other operations.
There was no mortality.
The investigators found that the pancreatic fistula rate was 50% after median pancreatectomy, 14% after distal pancreatectomy, and 14% after enucleation.
In addition, diabetes occurred in 3 patients after distal pancreatectomy, as well as 3 patients after median pancreatectomy with duct occlusion.
Dr Balzano's team concluded, "When indicated, enucleation is the operation of choice for a nonmalignant neoplasm of the pancreatic body".
"With respect to distal resection, the higher fistula rate of median pancreatectomy with pancreaticojejunostomy could be the price for a better long-term endocrine function".
"Median pancreatectomy with duct occlusion had worse operative results and no long-term advantages".