Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland).
Human Genetic Resources Center, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland).
Med Sci Monit. 2022 Apr 10;28:e935685. doi: 10.12659/MSM.935685.
BACKGROUND Pancreaticoduodenectomy (PD) and distal pancreatectomy with splenectomy (DPS) are considered the standard procedures for pancreatic lesions. However, long-term metabolic consequences of PD and DPS applied for benign or low-grade malignant tumors need to be addressed. This study aimed to investigate the short- and long-term outcomes of organ-sparing pancreatectomy for benign or low-grade malignant pancreatic tumors in our institution. MATERIAL AND METHODS The clinical data of 101 patients with benign or low-grade malignant pancreatic tumors who underwent organ-sparing pancreatectomy from January 2009 to September 2021 were retrospectively analyzed, including 40 tumor enucleations (EN), 22 central pancreatectomies (CP), 25 spleen-preserving distal pancreatectomies (SPDP), 7 pylorus-preserving pancreaticoduodenectomies (PPPD) and 7 duodenum-preserving pancreatic head resections (DPPHR). RESULTS The mean operative time, intraoperative blood loss, and length of hospital stay were 182.9±74.6 min, 191.9±127.8 mL, and 11.6±8.1 days, respectively. EN had the shortest operative time, while DPPHR had the longest operative time. The mean intraoperative blood loss of DPPHR and PPPD was significantly greater than the others (all P<0.05). The length of hospital stay of PPPD was longest. The overall morbidity was 33.6%. The reoperation rate was 1.0% and there was no mortality. The incidence of pancreatic endocrine insufficiency and exocrine insufficiency were 5.9% and 6.9%, respectively. None patients had tumor recurrence during the follow-up period. CONCLUSIONS Organ-sparing pancreatectomy is associated with acceptable perioperative risk and postoperative complications and better long-term outcomes in the aspects of preservation of function and curability in benign or low-grade malignant pancreatic tumors.
胰十二指肠切除术（PD）和胰体尾切除术联合脾脏切除术（DPS）被认为是胰腺病变的标准治疗方法。然而，PD 和 DPS 应用于良性或低级别恶性肿瘤的长期代谢后果仍需解决。本研究旨在探讨我院采用保留器官的胰腺切除术治疗良性或低级别恶性胰腺肿瘤的短期和长期疗效。
回顾性分析 2009 年 1 月至 2021 年 9 月期间我院 101 例接受保留器官的胰腺切除术治疗的良性或低级别恶性胰腺肿瘤患者的临床资料，包括肿瘤剜除术（EN）40 例、胰中段切除术（CP）22 例、保留脾脏的胰体尾切除术（SPDP）25 例、保留幽门的胰十二指肠切除术（PPPD）7 例和保留十二指肠的胰头切除术（DPPHR）7 例。
平均手术时间、术中出血量和住院时间分别为 182.9±74.6min、191.9±127.8mL 和 11.6±8.1d。EN 的手术时间最短，而 DPPHR 的手术时间最长。DPPHR 和 PPPD 的术中出血量显著大于其他术式（均 P<0.05）。PPPD 的住院时间最长。总并发症发生率为 33.6%。再次手术率为 1.0%，无死亡病例。胰腺内分泌和外分泌功能不全的发生率分别为 5.9%和 6.9%。随访期间无肿瘤复发。
保留器官的胰腺切除术治疗良性或低级别恶性胰腺肿瘤具有可接受的围手术期风险和术后并发症发生率，在保留功能和治愈方面具有更好的长期疗效。
