Total pancreatectomy: Indications, operative technique, and results: A single centre experience and review of literature

被引：45

作者：

Casadei R. ^{[1
]}

Monari F. ^{[1
]}

Buscemi S. ^{[1
]}

Laterza M. ^{[1
]}

Ricci C. ^{[1
]}

Rega D. ^{[1
]}

D'Ambra M. ^{[1
]}

Pezzilli R. ^{[2
]}

Calculli L. ^{[3
]}

Santini D. ^{[3
]}

Minni F. ^{[1
]}

机构：

[1] Dipto. di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, 40138 Bologna

[2] Dipartimento di Medicina Interna e Gastroenterologia, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Bologna

[3] Dipartimento di Scienze Radiologiche e Istocitopatologiche, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Bologna

来源：

Updates in Surgery | 2010年 / 62卷 / 1期

关键词：

Pancreatic cancer; Pylorus preserving; Spleen preserving; Total pancreatectomy;

D O I：

10.1007/s13304-010-0005-z

中图分类号：

学科分类号：

摘要：

The aims of this study were to identify the indications to perform a total pancreatectomy and to evaluate the outcome and quality of life of the patient who underwent this operation. A retrospective analysis of a prospective database, regarding all the patients who underwent total pancreatectomy from January 2006 to June 2009, was carried out. Perioperative and outcome data were analyzed in two different groups: ductal adenocarcinoma (group 1) and non-ductal adenocarcinoma (group 2). Twenty (16.9%) total pancreatectomies out of 118 pancreatic resections were performed. Seven (35.0%) patients were affected by ductal adenocarcinoma (group 1) and the remaining 13 (65.0%) by pancreatic diseases different from ductal adenocarcinoma (group 2) [8 (61.5%) intraductal pancreatic mucinous neoplasms, 2 (15.4%) well-differentiated neuroendocrine carcinomas, 2 (15.4%) pancreatic metastases from renal cell cancer and, finally, 1 (7.7%) chronic pancreatitis]. Eleven patients (55%) underwent primary elective total pancreatectomy; nine (45%) had a completion pancreatectomy previous pancreaticoduodenectomy. Primary elective total pancreatectomy was significantly more frequent in group 2 than in group 1. Early and long-term postoperative results were good without significant difference between the two groups except for the disease-free survival that was significantly better in group 2. The follow-up examinations showed a good control of the apancreatic diabetes and of the exocrine insufficiency without differences between the two groups. In conclusion, currently, total pancreatectomy is a standardized and safe procedure that allows good early and late results. Its indications are increasing because of the more frequent diagnose of pancreatic disease that involved the whole gland as well as intraductal pancreatic mucinous neoplasm, neuroendocrine tumors and pancreatic metastases from renal cell cancer. © 2010 Springer-Verlag.

引用

页码：41 / 46

页数：5

共 20 条

[1]

Rockey E.W., Total pancreatectomy for carcinoma: Case report, Ann Surg, 118, pp. 603-611, (1943)

[2]

Remine W.H., Priestley J.T., Judd E.S., Et al., Total pancrea-tectomy, Ann Surg, 172, pp. 595-604, (1970)

[3]

Sarr M.G., Behrns K.E., Van Heerden J.A., Total pancreatectomy: An objective analysis of its use in pancreatic cancer, Hepato-Gastroenterology, 40, 5, pp. 418-421, (1993)

[4]

Cuillerier E., Cellier C., Palazzo L., Deviere J., Wind P., Rickaert F., Cugnenc P.-H., Cremer M., Barbier J.-P., Outcome after surgical resection of intraductal papillary and mucinous tumors of the pancreas, American Journal of Gastroenterology, 95, 2, pp. 441-445, (2000)

[5]

Wente M.N., Kleeff J., Esposito I., Hartel M., Muller M.W., Frohlich B.E., Buchler M.W., Friess H., Renal cancer cell metastasis into the pancreas: A single-center experience and overview of the literature, Pancreas, 30, 3, pp. 218-222, (2005)

[6]

Inagaki M., Obara M., Kino S., Goto J., Suzuki S., Ishizaki A., Tanno S., Kohgo Y., Tokusashi Y., Miyokawa N., Kasai S., Pylorus-preserving total pancreatectomy for an intraductal papillary-mucinous neoplasm of the pancreas, J Hepatobiliary Pancreat Surg, 14, pp. 263-269, (2007)

[7]

Heidt D.G., Burant C., Simeone D.M., Total pancreatectomy: Indications, operative technique, and postoperative sequelae, J Gastrointest Surg, 11, pp. 209-216, (2007)

[8]

Muller M.W., Friess H., Kleeff J., Dahmen R., Wagner M., Hinz U., Breisch-Girbig D., Ceyhan G.O., Buchler M.W., Is there still a role for total pancreatectomy?, Ann Surg, 246, pp. 966-975, (2007)

[9]

Garcea G., Weaver J., Phillips J., Pollard C.E., Ilouz S.C., Webb M.A., Berry D.P., Dennison A.R., Total pancreatectomy with and without islet cell transplantation for chronic pancreatitis, Pancreas, 38, pp. 1-7, (2009)

[10]

Aaronson N.K., Ahmedzai S., Bergman B., Bullinger M., Cull A., Duez N.J., Filiberti A., Flechtner H., Fleishman S.B., De Haes J.C.J.M., Kaasa S., Klee M., Osoba D., Razavi D., Rofe P.B., Schraub S., Sneeuw K., Sullivan M., Takeda F., The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology, Journal of the National Cancer Institute, 85, 5, pp. 365-376, (1993)

← 1 2 →