Nishi Masaaki, Kawasaki Hideki, Fujii Masahiko, Nagahashi Miya, Obatake Masayoshi, Shirai Makoto, Yamamoto Koji, Harada Masamitsu
Department of General and Digestive Surgery, Ehime Prefectural Central Hospital, 83 Kasuga-cho, Matsuyama, Ehime 770-8503 Japan.
Clin J Gastroenterol. 2014 Jun;7(3):251-4. doi: 10.1007/s12328-014-0472-8. Epub 2014 Mar 19.
Multifocal or continuous pancreatic lesion is identified frequently but finding an appropriate surgical approach is quite challenging. Total pancreatectomy is a useful procedure. However, postoperative endocrine and exocrine disturbance is inevitable. Recently, the safety and feasibility of parenchyma preserving pancreatectomy, including middle-preserving pancreatectomy (MPP), have been reported. MPP is a combined procedure of pancreaticoduodenectomy and distal pancreatectomy, while preserving the body of the pancreas, for cases of multifocal pancreatic lesions. So far, there have only been a few reports that have described MPP. We report a case of MPP for multifocal intraductal papillary mucinous neoplasms of the pancreas, describe the surgical procedure, and discuss the feasibility of MPP as parenchyma-preserving pancreatectomy with reference to the literature.
多灶性或连续性胰腺病变经常被发现，但找到合适的手术方法颇具挑战性。全胰切除术是一种有效的手术方式。然而，术后内分泌和外分泌功能紊乱是不可避免的。近来，已报道了包括保留中段胰腺切除术（MPP）在内的保留胰腺实质切除术的安全性和可行性。MPP是一种胰十二指肠切除术和远端胰腺切除术的联合手术，在多灶性胰腺病变的病例中保留胰腺体部。到目前为止，仅有少数报告描述了MPP。我们报告一例胰腺多灶性导管内乳头状黏液性肿瘤行MPP的病例，描述手术过程，并参考文献讨论MPP作为保留胰腺实质切除术的可行性。
