Small amounts of tissue preserve pancreatic function: Long-term follow-up study of middle-segment preserving pancreatectomy.

摘要: Middle-segment preserving pancreatectomy (MPP) is a novel procedure for treating multifocal lesions of the pancreas while pancreatic function. However, long-term function after this remains unclear. The aims current study are to investigate short- and outcomes, especially endocrine function, MPP. From September 2011 December 2015, 7 patients underwent MPP in our institution, 5 cases with outcomes were further analyzed retrospective manner. Percentage tissue preservation was calculated using computed tomography volumetry. Serum insulin C-peptide levels oral glucose challenge evaluated patients. Beta-cell secreting including modified homeostasis model assessment beta-cell (HOMA2-beta), area under curve (AUC) C-peptide, index compared those pancreaticoduodenectomy (PD) total pancreatectomy. Exocrine assessed based on questionnaires. Our case series included 3 women 2 men, median age 50 (37–81) years. Four pylorus-preserving PD together distal (DP), 1 spleen preserved. The remaining patient Beger spleen-preserving DP. Median operation time estimated intraoperative blood loss 330 (250–615) min 800 (400–5500) mL, respectively. Histological examination revealed metastatic lesion pancreas, chronic pancreatitis, neuroendocrine tumor. Major postoperative complications delayed gastric emptying fistula. Imaging studies showed that segments representing 18.2% 39.5% good supply had been With 35.0 months follow-ups functions, only developed new-onset diabetes mellitus 4 preoperatively euglycemic parameters group quite comparable Whipple procedure, seemed better than No symptoms hypoglycemia identified any patient, although half reported exocrine insufficiency. In conclusion, feasible effective middle-segment sparing multicentric exhibit satisfied surgery.