INTRODUCTION: Pancreatectomies increase the risk of postoperative pancreatic fistula (POPF) and pancreatic insufficiency. Pancreatic enucleation preserves pancreatic parenchyma, lowers the risk of pancreatic insufficiency, but may induce specific complications (tumor recurrence or pancreatic fistulization). The aim of this study was to determine the risk factors for POPF following a pancreatic enucleation. METHODS: A retrospective analysis was designed based on data from patients who underwent pancreatic enucleation in five university hospitals (1998-2008). The presence of a pancreatic fistula was determined according to the criteria of the International Study Group of Pancreatic Fistula (Bassi et al. Surgery 138:8-13, 2005). RESULTS: Fifty-two patients (mean age 52 years) were included. Histological analysis revealed 35 endocrine tumors (68.6 %), 6 mucinous and 2 serous cyst adenomas, 2 metastases of renal cancer, and 8 benign tumors. Nineteen patients (36.5%) suffered postoperative complications including 14 POPF (27 %). Median postoperative hospital stay was 12.9 days; 9.1 days without POPF versus 29 days with POPF (p < 0.05). Size of the tumor, its location, histological differentiation, and use of somatostatin analogs were not predictors for POPF. We defined the cutoff for POPF at a distance of 2 mm from the main pancreatic duct based on 60% risk (≤2 mm) versus 19 % (>2 mm) of POPF (p < 0.01). With a mean follow-up of 30.8 months, one patient experienced recurrence of the tumor. No patients exhibited a new onset of diabetes or pancreatic insufficiency. CONCLUSION: Enucleation for resection of pancreatic tumors located at less than or equal to two 2 mm from the main pancreatic duct is a risk factor for POPF. Enucleation is a safe and effective treatment for benign or borderline pancreatic tumors.
INTRODUCTION: Pancreatectomies increase the risk of postoperative pancreatic fistula (POPF) and pancreatic insufficiency. Pancreatic enucleation preserves pancreatic parenchyma, lowers the risk of pancreatic insufficiency, but may induce specific complications (tumor recurrence or pancreatic fistulization). The aim of this study was to determine the risk factors for POPF following a pancreatic enucleation. METHODS: A retrospective analysis was designed based on data from patients who underwent pancreatic enucleation in five university hospitals (1998-2008). The presence of a pancreatic fistula was determined according to the criteria of the International Study Group of Pancreatic Fistula (Bassi et al. Surgery 138:8-13, 2005). RESULTS: Fifty-two patients (mean age 52 years) were included. Histological analysis revealed 35 endocrine tumors (68.6 %), 6 mucinous and 2 serous cyst adenomas, 2 metastases of renal cancer, and 8 benign tumors. Nineteen patients (36.5%) suffered postoperative complications including 14 POPF (27 %). Median postoperative hospital stay was 12.9 days; 9.1 days without POPF versus 29 days with POPF (p < 0.05). Size of the tumor, its location, histological differentiation, and use of somatostatin analogs were not predictors for POPF. We defined the cutoff for POPF at a distance of 2 mm from the main pancreatic duct based on 60% risk (≤2 mm) versus 19 % (>2 mm) of POPF (p < 0.01). With a mean follow-up of 30.8 months, one patient experienced recurrence of the tumor. No patients exhibited a new onset of diabetes or pancreatic insufficiency. CONCLUSION: Enucleation for resection of pancreatic tumors located at less than or equal to two 2 mm from the main pancreatic duct is a risk factor for POPF. Enucleation is a safe and effective treatment for benign or borderline pancreatic tumors.
Authors: Jean-Yves Mabrut; Laureano Fernandez-Cruz; Juan Santiago Azagra; Claudio Bassi; Georges Delvaux; Joseph Weerts; Jean-Michel Fabre; Jean Boulez; Jacques Baulieux; Jean-Louis Peix; Jean-François Gigot Journal: Surgery Date: 2005-06 Impact factor: 3.982
Authors: Michael W Müller; Helmut Friess; Jörg Kleeff; Ulf Hinz; Moritz N Wente; Daniel Paramythiotis; Pascal O Berberat; Güralp O Ceyhan; Markus W Büchler Journal: Ann Surg Date: 2006-12 Impact factor: 12.969
Authors: Yasmine Assadipour; Saïd C Azoury; Nicholas N Schaub; Young Hong; Robert Eil; Suzanne M Inchauste; Seth M Steinberg; Aradhana M Venkatesan; Steven K Libutti; Marybeth S Hughes Journal: Am J Surg Date: 2015-12-12 Impact factor: 2.565
Authors: Maria G Sacco Casamassima; Colin D Gause; Seth D Goldstein; Fizan Abdullah; Avner Meoded; Jeffrey R Lukish; Christopher L Wolfgang; John Cameron; David J Hackam; Ralph H Hruban; Paul M Colombani Journal: Pediatr Surg Int Date: 2016-06-30 Impact factor: 1.827
Authors: Tommaso Giuliani; Giovanni Marchegiani; Mark D Girgis; Stefano Francesco Crinò; Venkataraman R Muthusamy; Laura Bernardoni; Antonio Pea; Marco Ramera; Salvatore Paiella; Luca Landoni; Armando Gabbrielli; Roberto Salvia; Timothy R Donahue; Claudio Bassi Journal: Surg Endosc Date: 2020-03-16 Impact factor: 4.584