Zhiwen Xiao1, Guopei Luo1, Zuqiang Liu1, Kaizhou Jin1, Jin Xu1, Chen Liu1, Liang Liu1, Quanxing Ni1, Jiang Long2, Xianjun Yu3. 1. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, No. 270 DongAn Road, Shanghai 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, No. 270 DongAn Road, Shanghai 200032, PR China; Pancreatic Cancer Institute, Fudan University, No. 270 DongAn Road, Shanghai 200032, PR China. 2. Pancreatic Cancer Institute, Fudan University, No. 270 DongAn Road, Shanghai 200032, PR China. Electronic address: longjiang@fudanpci.org. 3. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, No. 270 DongAn Road, Shanghai 200032, PR China; Department of Oncology, Shanghai Medical College, Fudan University, No. 270 DongAn Road, Shanghai 200032, PR China; Pancreatic Cancer Institute, Fudan University, No. 270 DongAn Road, Shanghai 200032, PR China. Electronic address: yuxianjunfudan@163.com.
Abstract
BACKGROUND: Standard pancreatectomy for benign and borderline pancreatic lesions involves resecting a substantial amount of normal pancreatic parenchyma and leads to a subsequent impairment of both exocrine and endocrine pancreatic functions. A limited resection such as enucleation is the preferred option for such neoplasms. However, enucleation is associated with a high risk of postoperative complications in some cases. This study evaluated the feasibility and outcomes of performing deep enucleation with Roux-en-Y pancreaticojejunostomy reconstruction. METHODS: This study included patients who underwent pancreatic lesion enucleation from February 2010 to April 2014 in our hospital. The clinical data were collected and retrospectively analyzed. RESULTS: This study examined 53 patients who underwent enucleation, 33 of the procedures included deep enucleation with Roux-en-Y pancreaticojejunostomy reconstruction. There was no mortality, and the morbidity rate was 66.7% in this group. No patients developed grade C pancreatic fistulas in both group. None of the patients developed tumor recurrence or exocrine or endocrine insufficiency at a median follow-up of 25 months. DISCUSSION: Enucleation with Roux-en-Y pancreaticojejunostomy reconstruction is a safe and feasible procedure for the treatment of benign and borderline pancreatic neoplasms adjacent to the common pancreatic duct. This procedure can effectively mitigate the limitations of simple enucleation.
BACKGROUND: Standard pancreatectomy for benign and borderline pancreatic lesions involves resecting a substantial amount of normal pancreatic parenchyma and leads to a subsequent impairment of both exocrine and endocrine pancreatic functions. A limited resection such as enucleation is the preferred option for such neoplasms. However, enucleation is associated with a high risk of postoperative complications in some cases. This study evaluated the feasibility and outcomes of performing deep enucleation with Roux-en-Y pancreaticojejunostomy reconstruction. METHODS: This study included patients who underwent pancreatic lesion enucleation from February 2010 to April 2014 in our hospital. The clinical data were collected and retrospectively analyzed. RESULTS: This study examined 53 patients who underwent enucleation, 33 of the procedures included deep enucleation with Roux-en-Y pancreaticojejunostomy reconstruction. There was no mortality, and the morbidity rate was 66.7% in this group. No patients developed grade C pancreatic fistulas in both group. None of the patients developed tumor recurrence or exocrine or endocrine insufficiency at a median follow-up of 25 months. DISCUSSION: Enucleation with Roux-en-Y pancreaticojejunostomy reconstruction is a safe and feasible procedure for the treatment of benign and borderline pancreatic neoplasms adjacent to the common pancreatic duct. This procedure can effectively mitigate the limitations of simple enucleation.
Authors: C E Cauley; H A Pitt; K M Ziegler; A Nakeeb; C M Schmidt; N J Zyromski; M G House; K D Lillemoe Journal: J Gastrointest Surg Date: 2012-04-24 Impact factor: 3.452
Authors: C Iacono; G Verlato; A Ruzzenente; T Campagnaro; C Bacchelli; A Valdegamberi; L Bortolasi; A Guglielmi Journal: Br J Surg Date: 2013-06 Impact factor: 6.939