• Hepato Gastroenterol · Mar 2004

    Comparative Study

    Surgical treatment for serous cystadenoma of pancreas--segmental pancreatectomy or conventional resection?

    • Cheng-Hsi Su, Yi-Ming Shyr, Wing-Yiu Lui, and Fang-Ku P'eng.
    • Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan. such@vghtpe.gov.tw
    • Hepato Gastroenterol. 2004 Mar 1;51(56):595-8.

    Background/AimsBenign tumors located in the neck or body of the pancreas are usually removed by left pancreatectomy or pancreaticoduodenectomy when enucleation is too risky for possible damage of the main pancreatic duct. But standard pancreatic resection has its potential operative risk and may result in loss of pancreatic parenchyme and cause impairment of pancreatic function. The aim of this study was to compare the results of segmental pancreatectomy, a limited resection of the mid-portion of the pancreas, and traditional extensive pancreatic resection, i.e. distal pancreatectomy or pancreaticoduodencetomy in patients with serous cystadenoma of the pancreas.MethodologyFrom January 1989 to February 2002, 19 patients with serous cystadenoma of the pancreas treated with pancreatic resection were reviewed. Among them segmental pancreatectomy was performed in 5 cases, distal pancreatectomy was carried out in 11, pancreaticoduodenectomy in 2 and total pancreatectomy in one patient.ResultsOperation time was significantly longer in segmental pancreatectomy than in distal pancreatectomy (P<0.001) and a greater blood loss was also noticed in the conventional resection. There was no operative mortality and the postoperative hospital stays were not different in any group. A higher rate of pancreatic fistula was encountered in segmental pancreatectomy, however all of the fistulas sealed off after conservative treatment. A trend of higher chance of developing postoperative diabetes was noticed in the conventional resection. Except for the patient who underwent total pancreatectomy no patient developed frank steatorrhea during long-term follow-up.ConclusionsSegmental pancreatectomy is a safe and technically feasible procedure in selected patients with benign pancreatic tumor. This procedure carries a similar surgical risk as that of standard operation, but avoids extensive pancreatic resection which in turn may preserve more pancreatic functions.

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