This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Pancreatic insufficiency after different resections for benign tumours. BJS 2008; 95: 85-91.
Published: 26th November 2007
Authors: M. Falconi, W. Mantovani, S. Crippa, G. Mascetta, R. Salvia, P. Pederzoli et al.
Background
Pancreatic resections for benign diseases may lead to long‐term endocrine/exocrine impairment. The aim of this study was to compare postoperative and long‐term results after different pancreatic resections for benign disease.
Method
Between 1990 and 1999, 62 patients underwent pancreaticoduodenectomy (PD), 36 atypical resection (AR) and 64 left pancreatectomy (LP) for benign tumours. Exocrine and endocrine pancreatic function was evaluated by 72‐h faecal chymotrypsin and oral glucose tolerance test.
Results
The incidence of pancreatic fistula was significantly higher after AR than after LP (11 of 36 versus seven of 64; P = 0·028). The long‐term incidence of endocrine pancreatic insufficiency was significantly lower after AR than after PD (P < 0·001). Exocrine insufficiency was more common after PD (P < 0·001) and LP (P = 0·009) than after AR. The probability of developing both endocrine and exocrine insufficiency was higher for PD and LP than for AR (32, 27 and 3 per cent respectively at 1 year; 58, 29 and 3 per cent at 5 years; P < 0·001).
Conclusion
Different pancreatic resections are associated with different risks of developing long‐term pancreatic insufficiency. AR represents the best option in terms of long‐term endocrine and exocrine function, although it is associated with more postoperative complications. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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