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CC BY 4.0 · Surg J (N Y) 2020; 06(04): e175-e179
DOI: 10.1055/s-0040-1718699
Case Report

Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases

Roza Panagis Moureletou 
1   2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece
,
Dimitrios Kalliouris 
1   2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece
,
Konstantinos Manesis
1   2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece
,
Sotirios Theodoroleas
1   2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece
,
Angeliki Bistaraki
2   Surgery Department, 417 Army Share Fund Hospital, Athens, Greece
,
George Boubousis
1   2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece
,
Efstathios Nikou 
1   2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece
› Author Affiliations Funding No funding was provided for this research.
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Abstract

Background Central pancreatectomy (CP), a partial resection of the pancreas, is indicated for the excision of neuroendocrine tumors (NETs) of the pancreas, when located at the neck or the proximal body. Specifically, CP is preferable in functional NET and in nonfunctional sized 1 to 2 cm or/with proliferation marker Ki67 < 20% (Grade I/II). Postoperative leakage from the remaining pancreas constitutes the most frequent complication of CP (up to 63%). The aim of our study was to share the experience of our center in CP for NET, with pancreaticojejunal anastomosis.

Methods In 1 year, we performed CP in two patients, following the aforementioned criteria. They presented with tumor of the body of the pancreas, which was found in random check with computed tomography, with negative hormonal blood tests and they underwent magnetic resonance imaging and endoscopic ultrasound/fine-needle biopsy/pathological examination.

Results The patients underwent CP with Roux-en-Y pancreaticojejunal anastomosis of the distal pancreatic stump and jejunal patch of the proximal pancreatic stump. Histological exam revealed NET sized 2.8 cm and 1.45 cm, Grade I and II, respectively. Postoperatively both patients developed small pancreatic leakage, which did not affect their physical condition and stopped after 20 and 30 days. No one needed pancreatic enzymes supplements or developed new-onset diabetes mellitus.

Conclusion CP provided adequate, functional remaining pancreatic tissue in both patients. Small leakages were treated conservatively and retreated without septic complications. As a result, CP might be considered as safe and effective technique for pancreatic neck/proximal body NET.

Keywords

central pancreatectomy - pancreaticojejunal anastomosis - pNET


Publication History

Received: 30 November 2019

Accepted: 19 May 2020

Article published online:
14 December 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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