Central (middle segment) pancreatectomy: a suitable operation for small lesions of the neck of the pancreas.

A 73-year-old male was worked up for persistent abdominal pain and found to have a 2.5 cm cystic lesion of the neck of the pancreas. At celiotomy the lesion was felt to be a benign cystic lesion and a central pancreatectomy consisting of removal of the lesion with one centimeter of pancreas on either side was performed. The proximal pancreatic duct was oversewn and the distal body and tail of the pancreas was drained into a Roux-en-Y limb of the jejunum. At present, there are 70 cases of central pancreatectomy published in the literature. Mortality of the operation is zero and the major complications of pancreatic fistula, delayed gastric emptying, pancreatitis and abscess, are all temporary and self limiting. Central pancreatectomy affords the opportunity to save normal pancreatic tissue thus avoiding the complications of exocrine pancreatic insufficiency, namely steatorrhea and endocrine pancreatic insufficiency namely diabetes.