Department of Surgery, Division of General and Hepato-pancreato-biliary, University of Verona Medical School, Verona, Italy.
Department of Surgery, Division of General and Hepato-pancreato-biliary, University of Verona Medical School, Verona, Italy,
Dig Surg. 2019;36(5):363-368. doi: 10.1159/000490198. Epub 2018 Jul 13.
Total dorsal pancreatectomy (TDP) is a conservative pancreatic resection that should be considered in cases of benign or low malignant tumors confined to the dorsal pancreas to preserve the viability of both digestive and biliary tracts, and to avoid the endocrine and metabolic consequences of total pancreatectomy. We report a new case of TDP and provide a literature review of this procedure.
The case reported was a 35-year-old female patient with a solid pseudopapillary tumor. We resected the dorsal segment of the pancreas while preserving the common bile duct, gastroduodenal artery, and pancreaticoduodenal arcades, and the spleen and splenic vessels. The MEDLINE® and Embase® databases were searched for English language studies, case series, or case reports published through August 31, 2017.
The postoperative course was uneventful and patient was discharged on postoperative day 11. The patient was alive and in good condition at the 10-year follow-up. To date in English literature, there are only 3 reported cases of TDP, and all cases were patients with intraductal papillary mucinous neoplasia and pancreas divisum. There was no postoperative mortality, and 2 grade B pancreatic fistulas healed 1 month postoperatively.
TDP is a feasible and safe operation for benign or low grade malignant pancreatic tumors involving the dorsal pancreas, as an alternative to total pancreatectomy.
全胰尾部切除术（TDP）是一种保守的胰腺切除术，适用于良性或低度恶性肿瘤局限于胰尾部的病例，以保留消化道和胆道的活力，并避免全胰切除术引起的内分泌和代谢后果。我们报告了一例新的 TDP 病例，并对该手术进行了文献复习。
报告的病例为 35 岁女性，患有实性假乳头状瘤。我们在保留胆总管、胃十二指肠动脉和胰十二指肠弓、脾脏和脾血管的情况下，切除了胰尾部。检索了 MEDLINE®和 Embase®数据库，以获取截至 2017 年 8 月 31 日发表的英文研究、病例系列或病例报告。
术后恢复顺利，患者于术后第 11 天出院。患者在 10 年随访时存活且状况良好。迄今为止，在英文文献中，仅有 3 例 TDP 的报道，所有病例均为胰管内乳头状黏液性肿瘤和胰腺分裂患者。无术后死亡病例，2 例 B 级胰瘘术后 1 个月愈合。
TDP 是一种可行且安全的手术，适用于涉及胰尾部的良性或低度恶性胰腺肿瘤，可作为全胰切除术的替代方法。
