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Abstract：
Introduction Central pancreatectomy (CP) represents an organ-preserving type of pancreatic resection. The procedure has been associated with improved long-term functional results, but increased postoperative morbidity rates, compared with the more radical resection types. The purpose of the present study was to present the outcomes of three consecutive CPs performed in our department. Materials and Methods Between January 2021 and January 2022, three patients (A, B, and C) were submitted to a CP in our department. Relevant patient data including data of the detailed preoperative assessment, operations notes, and recovery charts were prospectively collected and reviewed for all subjects. A scheduled follow-up, at the outpatient clinic, was conducted to assess the long-term functional results. Results The postoperative course of patient A, a 56-year-old male, was complicated by a grade C postoperative pancreatic fistula that required a reoperation. Patient B, a 66-year-old female, developed a biochemical leak that resolved spontaneously while patient C, a 64-year-old male, had a completely uneventful recovery. The length of hospital stay for the three patients was 24, 12, and 8 days, respectively. Regarding the long-term results, patient B was lost to follow-up while both patient A and C were followed up, as outpatients, 21 and 10 months after the operation. During follow-up, in patient A, we did not record the presence of symptoms consistent with pancreatic exocrine insufficiency, the hemoglobin A1C (HbA1C) levels were 7.1% while no additional medications were needed to be prescribed to maintain the glycemic control following surgery. In patient C, a significant weight loss was recorded (body mass index reduction of 11 kg/m 2 ) without however the presence of malabsorption-specific symptoms. The HbA1C levels were 7.7% and optimal glycemic control was achieved with oral antiglycemic agents alone. Conclusion CP should be regarded as a type of pancreatic resection with certain and very limited oncological indications. An approach of balancing the advantages out of the superior postoperative functional results with the drawbacks of the increased procedure-associated morbidity could highlight the patient group that could potentially experience benefits out of this limited type of resection.
摘要：
介绍中央胰腺切除术（CP）代表一种器官保留型胰腺切除术。该程序与改善的长期功能结果有关，但是术后发病率增加，与更根治性的切除类型相比。本研究的目的是介绍在我们部门进行的三个连续CP的结果。材料与方法2021年1月至2022年1月，3名患者(A，B,和C)提交给我们部门的CP。相关患者数据，包括详细的术前评估数据，操作说明，前瞻性地收集和审查了所有受试者的恢复图。预定的后续行动，在门诊，进行评估的长期功能结果。结果患者A的术后病程,一个56岁的男性,并发C级术后胰瘘，需要再次手术。病人B,一位66岁的女性,出现了生化渗漏，在病人C时自发解决，一个64岁的男性,有一个完全平静的恢复。3名患者的住院时间分别为24、12和8天,分别。关于长期结果，病人B失去了随访，而病人A和C都得到了随访，作为门诊病人，术后21和10个月。随访期间,患者A,我们没有记录与胰腺外分泌功能不全一致的症状，血红蛋白A1C(HbA1C)水平为7.1%,同时无需额外处方药物来维持手术后的血糖控制.病人C,体重显著减轻(体重指数降低11kg/m2),但无吸收不良症状.HbA1C水平为7.7％，仅口服抗血糖药即可达到最佳血糖控制。结论CP应被视为一种胰腺切除术，具有一定的肿瘤指征。从优越的术后功能结果中平衡优势与增加的手术相关发病率的缺点的方法可能会突出显示患者群体，这些患者群体可能会从这种有限的切除类型中获益。
