Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Surgery, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2022 Oct 1;85(10):981-986. doi: 10.1097/JCMA.0000000000000771. Epub 2022 Jul 8.
This study aimed to clarify the feasibility and justification of pancreatic head sparing (PHS) enucleation for patients with agenesis of the dorsal pancreas (ADP) associated with a solid pseudopapillary tumor (SPT).
Data of the SPT patients with and without ADP, including clinical presentations, surgical options, and surgical and survival outcomes, were recruited for comparison.
A total of 31 patients with SPTs were included, three of whom displayed ADP and underwent PHS enucleation. Surgical complications were comparable between the groups. Overall, the 5- and 10-year disease-free survival rates were 100% and 90%, respectively. The 20- and 25-year overall survival rates were 100% and 66.7%, respectively. Only one patient (3.2%) developed tumor recurrence 7.3 years after pancreatectomy for an SPT with lymph node involvement, and the patient survived 24.5 years after the initial operation. No tumor recurrence occurred in any patient with ADP after PHS enucleation.
PHS enucleation seems to be feasible and justifiable for SPT patients with ADP in terms of surgical and survival outcomes, and this approach could be recommended to avoid pancreatic insufficiency.
本研究旨在阐明对于伴有胰腺背侧发育不全（ADP）的实性假乳头状瘤（SPT）患者行胰头保留（PHS）切除术的可行性和合理性。
我们招募了伴有和不伴有 ADP 的 SPT 患者的数据进行比较，包括临床表现、手术选择以及手术和生存结果。
共纳入 31 例 SPT 患者，其中 3 例存在 ADP 并接受了 PHS 切除术。两组的手术并发症相当。总体而言，5 年和 10 年无疾病生存率分别为 100%和 90%。20 年和 25 年总生存率分别为 100%和 66.7%。仅有 1 例（3.2%）患者在 SPT 伴淋巴结受累行胰切除术 7.3 年后出现肿瘤复发，该患者在初始手术后存活了 24.5 年。在接受 PHS 切除术的 ADP 患者中，无一例发生肿瘤复发。
从手术和生存结果来看，PHS 切除术似乎对于伴有 ADP 的 SPT 患者是可行且合理的，这种方法可以避免胰腺功能不全。
