Central pancreatectomy for early-stage pancreatic ductal adenocarcinoma: a single-center case\u2013control study

Hao Gao,Wentao Gao,Nan Lyu,Junli Wu,Lingdi Yin,Jishu Wei,Kai Zhang,Yi Miao,Yunpeng Peng,Guangfu Wang,Kuirong Jiang,Tongtai Liu,Yong Gao

doi:10.1007/s00423-019-01766-1

Abstract

PurposeCentral pancreatectomy (CP) has been applied for treating benign and low-grade malignant tumors in pancreatic neck, but studies regarding CP for pancreatic ductal adenocarcinoma (PDAC) are quite limited. We aimed to investigate the role of central pancreatectomy in the treatment of PDAC in the neck of the pancreas.MethodsPatients who underwent CP at our hospital between 2009 and 2016 were identified. Patients treated by distal pancreatectomy (DP) were matched according to the tumor size, location, and staging. The surgical and survival outcomes were compared between the CP and DP groups.ResultsNine patients had CP. Five (56%) had postoperative complications and three (33%) had clinically significant (grade B + C) fistula. No significant difference was found between the CP and DP groups for the rate of overall morbidity, pancreatic fistula, reoperation, and readmission. Tumor size was smaller in the CP group compared to the DP group. The mortality of both groups was zero. The median postoperative survival was similar between the two groups (20.4 months for CP vs 19.4 months for DP, P = 0.842).ConclusionsCP is safe for patients with small PDAC at the neck of the pancreas. Considering the good preservation of pancreatic endocrine and exocrine functions, CP could be considered as an alternative procedure for single small PDAC in pancreatic neck.

Highlights

Neoplasms located in the neck of pancreas pose a challenge to pancreatic surgeons
Enucleation has been reported to be alternative procedure to radical pancreatectomy [12,13,14] and patients treated by pyloruspreserving pancreaticoduodenectomy (PPPD) could achieve similar long-term survival as patients undergoing pancreaticoduodenectomy (PD) [15]
A total of 64 patients were enrolled in the present study with 9 patients undergoing Central pancreatectomy (CP) and 55 with distal pancreatectomy (DP)

Summary

Introduction

Neoplasms located in the neck of pancreas pose a challenge to pancreatic surgeons. Tumors in this location are resected by distal pancreatectomy (DP) [1]. Central pancreatectomy (CP) has been proposed as an. Hao Gao and Tongtai Liu contributed to this work. Jishu Wei and Yi Miao contributed to this article and are considered as joint corresponding authors. Data in favor of limited resections for pancreatic tumors have been accumulating. Enucleation has been reported to be alternative procedure to radical pancreatectomy [12,13,14] and patients treated by pyloruspreserving pancreaticoduodenectomy (PPPD) could achieve similar long-term survival as patients undergoing pancreaticoduodenectomy (PD) [15]. There is concern that CP is not an adequate oncological procedure

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