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Войти в исследования Chirurgie; memoires de l'Academie de chirurgie · 1998
[Medial pancreatectomy with pancreatogastric anastomosis in pancreatic neoplasms].
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Partensky C, Apa D, Marchal F, Méziat A, Berger F
Аннотация
AIM OF THE STUDY: To report a personal series of ten patients who underwent a medial pancreatectomy with pancreaticogastrostomy for tumor of the pancreas.
MATERIAL AND METHODS: An equal number of five patients had solid and cystic tumors. The solid tumors were all endocrine and included two cases of insulinoma and solitary cases of VIPoma, glucagonoma, and non-secreting tumor. Five patients had a cystic tumor which was in two cases a serous cystadenoma, and in the other cases, a mucinous cystadenoma, a solid pseudopapillary tumor, and a solitary hydatid cyst of the pancreas. The operative procedure included a middle segment pancreatectomy, a suture of the proximal pancreatic stump, an anastomosis of the distal pancreatic stump with the stomach and an external transgastric drainage of the distal main pancreatic duct.
RESULTS: In the postoperative course, a sero-hematic collection close to the anastomosis occurred in four patients and required external drainage in three cases. All patients recovered without sequela of pancreatic dysfunction.
CONCLUSION: This series confirms the place of medial pancreatectomy in resection of non-enucleable tumors of the middle part of the pancreas. It also shows that pancreaticogastrostomy is a technical simplification compared to Roux-en Y pancreaticojejunostomy in this particular modality of pancreatectomy.
MATERIAL AND METHODS: An equal number of five patients had solid and cystic tumors. The solid tumors were all endocrine and included two cases of insulinoma and solitary cases of VIPoma, glucagonoma, and non-secreting tumor. Five patients had a cystic tumor which was in two cases a serous cystadenoma, and in the other cases, a mucinous cystadenoma, a solid pseudopapillary tumor, and a solitary hydatid cyst of the pancreas. The operative procedure included a middle segment pancreatectomy, a suture of the proximal pancreatic stump, an anastomosis of the distal pancreatic stump with the stomach and an external transgastric drainage of the distal main pancreatic duct.
RESULTS: In the postoperative course, a sero-hematic collection close to the anastomosis occurred in four patients and required external drainage in three cases. All patients recovered without sequela of pancreatic dysfunction.
CONCLUSION: This series confirms the place of medial pancreatectomy in resection of non-enucleable tumors of the middle part of the pancreas. It also shows that pancreaticogastrostomy is a technical simplification compared to Roux-en Y pancreaticojejunostomy in this particular modality of pancreatectomy.