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CC BY 4.0 · Surg J (N Y) 2024; 10(01): e20-e24
DOI: 10.1055/s-0044-1782655
Case Report

Central Pancreatectomy: Balancing between the Favorable Functional Results and the Increased Associated Morbidity

Dimitrios Symeonidis
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
,
Ismini Paraskeva
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
,
Athina A. Samara 
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
,
Labrini Kissa
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
,
Alexandros Valaroutsos
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
,
Eleana Petsa
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
,
Konstantinos Tepetes
1   Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa, Greece
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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/m2) 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.

Keywords

central pancreatectomy - functional results - morbidity - postoperative pancreatic fistula


Publication History

Received: 31 July 2023

Accepted: 27 February 2024

Article published online:
14 March 2024

© 2024. 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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