Central Pancreatectomy Is a Better Choice for Benign or Low-Grade Malignant Pancreatic Tumors in the Neck and Body of the Pancreas: A Single-Center Retrospective Analysis of 296 Cases

Abstract

Introduction: It remains controversial whether central pancreatectomy (CP) can remained more remnant pancreatic endocrine and exocrine function after surgery. This study aimed to evaluate the safety and efficacy of CP compared with distal pancreatectomy (DP) for benign or low-grade malignant pancreatic tumors in the neck and body of the pancreas. Methods: This retrospective study enrolled 296 patients who underwent CP (34) or DP (262) for benign and low-malignant neoplasms in a single hospital between January 2016 and March 2020. Peri- and postoperative outcomes, and endocrine/exocrine function were evaluated. Results: No significant difference was observed in overall morbidity or clinically relevant POPF (grades B/C) between the two groups. Delayed gastric emptying occurred more frequently in the CP group (29.4% vs. 15.3%; P<0.005), but most of them were grade A. No patient has new-onset or aggravated DM in CP group, while forty patients had endocrine function deficiency in DP group (p<0.005) . There were only two patients has diarrhea immediately after surgery, which was significantly lower compared with DP group (46, p<0.05). Significant differences were observed in diarrhea 12 months after surgery between the two groups (0% vs. 9.5% ; P<0.005). Conclusions: CP was a generally safe procedure, and has similar postoperative morbidity compared with DP. CP remained more remnant pancreatic endocrine and exocrine function. We recommended CP a better choice to treat benign or low-grade malignant neoplasms in suitable patients.