Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 28, 2009; 15(32): 4044-4048
Published online Aug 28, 2009. doi: 10.3748/wjg.15.4044
Conservative resection for benign tumors of the proximal pancreas
Hai Huang, Xin Dong, Shun-Liang Gao, Yu-Lian Wu
Hai Huang, Xin Dong, Shun-Liang Gao, Yu-Lian Wu, Department of Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China
Author contributions: Acquisition of data was performed by Huang H, Dong X, and Gao SL; Huang H and Dong X analyzed and interpreted the data, and were also involved in writing the manuscript; Wu YL designed the study and revised the paper.
Correspondence to: Yu-Lian Wu, Professor, Department of Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. yulianwu2003@yahoo.ca
Telephone: +86-571-87784604
Fax: +86-571-87784604
Received: June 15, 2009
Revised: July 21, 2009
Accepted: July 28, 2009
Published online: August 28, 2009
Abstract

AIM: To evaluate the safety and long-term prognosis of conservative resection (CR) for benign or borderline tumor of the proximal pancreas.

METHODS: We retrospectively analyzed 20 patients who underwent CR at the Second Affiliated Hospital of Zhejiang University School of Medicine between April 2000 and October 2008. For pancreaticojejunostomy, a modified invagination method, continuous circular invaginated pancreaticojejunostomy (CCI-PJ) was used. Modified continuous closed lavage (MCCL) was performed for patients with pancreatic fistula.

RESULTS: The indications were: serous cystadenomas in eight patients, insulinomas in six, non-functional islet cell tumors in three and solid pseudopapillary tumors in three. Perioperative mortality was zero and morbidity was 25%. Overall, pancreatic fistula was present in 25% of patients. At a mean follow up of 42.7 mo, all patients were alive with no recurrence and no new-onset diabetes mellitus or exocrine dysfunction.

CONCLUSION: CR is a safe and effective procedure for patients with benign tumors in the proximal pancreas, with careful CCI-PJ and postoperative MCCL.

Keywords: Adenoma; Islet cell; Conservative resection; Cystadenoma; Enucleation; Insulinoma; Pancreatectomy; Pancreatic fistula; Pancreatic neoplasms