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Medline ® Abstract for Reference 66

of 'Surgical resection of sporadic pancreatic neuroendocrine tumors'

A central pancreatectomy for benign or low-grade malignant neoplasms.
Hirono S, Tani M, Kawai M, Ina S, Nishioka R, Miyazawa M, Shimizu A, Uchiyama K, Yamaue H
J Gastrointest Surg. 2009;13(9):1659.
INTRODUCTION: A central pancreatectomy is a parenchyma-sparing procedure that is performed to reduce long-term endocrine and exocrine insufficiency.
METHOD: In this study, we analyzed the perioperative course, the frequency of postoperative onset of diabetes mellitus, and long-term change of body weight in patients undergoing a central pancreatectomy, in comparison to the patients undergoing a distal pancreatectomy for low-grade neoplasms including cystic neoplasms and neuroendocrine tumors.
RESULTS AND DISCUSSION: The rate of postoperative complications including grade B/C pancreatic fistula was no different between both groups. Only one patient undergoing a central pancreatectomy (4.7%) developed new onset of mild diabetes, whereas 35% in the distal pancreatectomy group developed new onset or worsening diabetes (p = 0.0129). The body weight in the distal pancreatectomy group was significant lower than that in the central pancreatectomy group at 1 and 2 years after surgery (1 year; P<0.0001, 2 years; P = 0.0055), and the body weight in the patients undergoing a central pancreatectomy improved to preoperative values within 2 years after surgery.
CONCLUSION: A central pancreatectomy is a safe procedure for the treatment of low-grade malignant neoplasms in the pancreatic body; the rate of onset of diabetes is minimal, and the body weight improves early in the postoperative course.
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.