International journal of surgery case reports · 2023
Middle segment pancreatectomy: Does it deserve a second chance? Report of three cases and review of the literature.
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Sekkat Hamza, Kada Ali, El Hamzaoui Jihane, Yaka Mbarek, Elhjouji Abderrahman, Ait Ali Abdelmounaïm
Аннотация
INTRODUCTION AND IMPORTANCE: Meddle segment pancreatectomy (MP) is a parenchyma-sparing surgical procedure that has recently been proposed for treatment of benign or attenuated malignant tumors. However, this procedure is not fully recognized.
CASE PRESENTATION: We herein report 3 patients undergoing MP for tumors of pancreas body and tail. The first patient was a 38-year-old woman with a neuroendocrine tumor, the second was a 42-year-old woman with a serous cystic neoplasm and the 3rd patient was 57 years old, with mucinous cystadenoma. A MP with spleen preservation was performed in the 3 patients, with ligatures of splenic vessels in the first patient. Only one patient developed a pancreatic fistula, which was managed medically. In our 3 patients, no endocrine or exocrine insufficiency was observed, but the first patient showed a disease recurrence with liver metastasis 3 years after surgery.
CLINICAL DISCUSSION: Middle pancreatectomy can not only avoid the pancreatic effects of extensive resections, but it is also a technique that has a very low operative or postoperative mortality rate.
CONCLUSION: MP is a feasible, safe procedure with several advantages, but which unfortunately remains rarely practiced.
CASE PRESENTATION: We herein report 3 patients undergoing MP for tumors of pancreas body and tail. The first patient was a 38-year-old woman with a neuroendocrine tumor, the second was a 42-year-old woman with a serous cystic neoplasm and the 3rd patient was 57 years old, with mucinous cystadenoma. A MP with spleen preservation was performed in the 3 patients, with ligatures of splenic vessels in the first patient. Only one patient developed a pancreatic fistula, which was managed medically. In our 3 patients, no endocrine or exocrine insufficiency was observed, but the first patient showed a disease recurrence with liver metastasis 3 years after surgery.
CLINICAL DISCUSSION: Middle pancreatectomy can not only avoid the pancreatic effects of extensive resections, but it is also a technique that has a very low operative or postoperative mortality rate.
CONCLUSION: MP is a feasible, safe procedure with several advantages, but which unfortunately remains rarely practiced.