Abstract：
OBJECTIVE: Central pancreatectomy (CP) offers parenchymal preservation compared to conventional distal pancreato-splenectomy for pancreatic neck and body tumours. However, it is associated with more morbidity. This study is aimed at evaluating the peri-operative and long-term functional outcomes, comparing central and distal pancreatectomies (DPs).
METHODS: Retrospective analysis of patients undergoing pancreatic resections for low-grade malignant or benign tumours in pancreatic neck and body was performed (from January 2007 to December 2022). Preoperative imaging was reviewed for all cases, and only patients with uninvolved pancreatic tail, whereby a CP was feasible, were included. Peri-operative outcomes and long-term functional outcomes were compared between CP and DP.
RESULTS: One hundred twenty-two (5.2%) patients, amongst the total of 2304 pancreatic resections, underwent central or distal pancreatectomy for low-grade malignant or benign tumours. CP was feasible in 55 cases, of which 23 (42%) actually underwent CP and the remaining 32 (58%) underwent DP. CP group had a significantly longer operative time [370 min (IQR 300-480) versus 300 min (IQR 240-360); p = 0.002]; however, the major morbidity (43.5% versus 37.5%; p = 0.655) and median hospital stay (10 versus 11 days; p = 0.312) were comparable. The long-term endocrine functional outcome was favourable for the CP group [endocrine insufficiency rate was 13.6% in central versus 42.8% in distal (p = 0.046)].
CONCLUSIONS: Central pancreatectomy offers better long-term endocrine function without any increased morbidity in low malignant potential or benign pancreatic tumours of neck and body region.
METHODS: Retrospective analysis of patients undergoing pancreatic resections for low-grade malignant or benign tumours in pancreatic neck and body was performed (from January 2007 to December 2022). Preoperative imaging was reviewed for all cases, and only patients with uninvolved pancreatic tail, whereby a CP was feasible, were included. Peri-operative outcomes and long-term functional outcomes were compared between CP and DP.
RESULTS: One hundred twenty-two (5.2%) patients, amongst the total of 2304 pancreatic resections, underwent central or distal pancreatectomy for low-grade malignant or benign tumours. CP was feasible in 55 cases, of which 23 (42%) actually underwent CP and the remaining 32 (58%) underwent DP. CP group had a significantly longer operative time [370 min (IQR 300-480) versus 300 min (IQR 240-360); p = 0.002]; however, the major morbidity (43.5% versus 37.5%; p = 0.655) and median hospital stay (10 versus 11 days; p = 0.312) were comparable. The long-term endocrine functional outcome was favourable for the CP group [endocrine insufficiency rate was 13.6% in central versus 42.8% in distal (p = 0.046)].
CONCLUSIONS: Central pancreatectomy offers better long-term endocrine function without any increased morbidity in low malignant potential or benign pancreatic tumours of neck and body region.
摘要：
目的：与传统的远端胰脾切除术相比，中央胰腺切除术（CP）对胰腺颈部和身体肿瘤具有实质保留作用。然而,它与更多的发病率有关。本研究旨在评估围手术期和长期功能结果，比较中央和远端胰腺切除术（DP）。
方法：回顾性分析2007年1月至2022年12月接受胰腺颈部和身体低度恶性或良性肿瘤切除的患者。所有病例的术前影像学检查，只有胰腺尾部未受累的患者，因此CP是可行的，包括在内。比较CP和DP的围手术期结果和长期功能结果。
结果：一百二十二例（5.2％）患者，在总共2304例胰腺切除术中，接受中央或远端胰腺切除术治疗低度恶性或良性肿瘤。55例CP是可行的，其中23例(42%)实际接受CP,其余32例(58%)接受DP.CP组的手术时间明显更长[370分钟（IQR300-480）比300分钟（IQR240-360）;p=0.002];然而，主要发病率(43.5%vs37.5%;p=0.655)和中位住院时间(10日vs11日;p=0.312)具有可比性.CP组的长期内分泌功能转归有利[中枢内分泌功能不全发生率为13.6%，远端为42.8%(p=0.046)]。
结论：中央胰腺切除术可提供更好的长期内分泌功能，而不会增加颈部和身体区域的低恶性潜能或良性胰腺肿瘤的发病率。
方法：回顾性分析2007年1月至2022年12月接受胰腺颈部和身体低度恶性或良性肿瘤切除的患者。所有病例的术前影像学检查，只有胰腺尾部未受累的患者，因此CP是可行的，包括在内。比较CP和DP的围手术期结果和长期功能结果。
结果：一百二十二例（5.2％）患者，在总共2304例胰腺切除术中，接受中央或远端胰腺切除术治疗低度恶性或良性肿瘤。55例CP是可行的，其中23例(42%)实际接受CP,其余32例(58%)接受DP.CP组的手术时间明显更长[370分钟（IQR300-480）比300分钟（IQR240-360）;p=0.002];然而，主要发病率(43.5%vs37.5%;p=0.655)和中位住院时间(10日vs11日;p=0.312)具有可比性.CP组的长期内分泌功能转归有利[中枢内分泌功能不全发生率为13.6%，远端为42.8%(p=0.046)]。
结论：中央胰腺切除术可提供更好的长期内分泌功能，而不会增加颈部和身体区域的低恶性潜能或良性胰腺肿瘤的发病率。
