Wang X, Tan CL, Song HY, Yao Q, Liu XB. Duodenum and ventral pancreas preserving subtotal pancreatectomy for low-grade malignant neoplasms of the pancreas: An alternative procedure to total pancreatectomy for low-grade pancreatic neoplasms. World J Gastroenterol 2017; 23(35): 6457-6466 [PMID: 29085195 DOI: 10.3748/wjg.v23.i35.6457]
Corresponding Author of This Article
Xu-Bao Liu, MD, PhD, Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, Sichuan Province, China. xbliu@medmail.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 21, 2017; 23(35): 6457-6466 Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6457
Table 1 Preoperative characteristics and final pathologic features of 23 patients in the duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy groups n (%)
Patient characteristics
DVPPST(n = 10)
TP (n = 13)
P vaule
Age (range, yr)
49 ± 16.9 (24-71)
56 ± 10.1 (40-70)
0.256
Gender (%)
0.680
Male
4 (40)
7 (54)
Female
6 (60)
6 (46)
Major comorbidity
CAD
0
1
1.000
COPD
1
2
1.000
DM
2
3
1.000
Hypertension
3
3
1.000
Preoperative symptoms
Incidental
0
2 (15)
0.486
Symptomatic (%)
10 (100)
11 (85)
Abdominal pain
4 (40)
6 (55)
1.000
Pancreatitis
1
4
0.339
Weight loss
1
4
0.339
Gastrointestinal symptoms
4
3
0.65
ASA score
1.000
I/II
7
10
III
3
3
Pathology (%)
0.411
IPMN
6 (60)
11 (85)
Low-grade moderate-grade dysplasia
2
1
0.515
High-grade dysplasia
3
4
0.644
Invasive carcinoma
1 (16.7)
5 (45.5)
0.333
Neuroendocrine tumor
2
1
G 2
2
1
1.000
SPT
2
1
Total invasive malignancy
1 (10)
5 (38.5)
0.179
Table 2 Intraoperative and postoperative outcomes of 23 patients after duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy
Table 3 Postoperative condition of supplementary therapy of 23 patients after duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy
Parameters
DPPSP(n = 10)
TP (n = 13)
P vaule
Enzymes replacement (cps/d)
0.9 ± 2.0
9.2 ± 2.2
< 0.001
Total insulin dose (U/d)
6.4 ± 14.0
29.7 ± 9.3
< 0.001
Diarrhea or steatorrhea
2
4
0.660
Hyperglycemia
0
5
0.046
Table 4 Postoperative condition of diabetes of 10 patients in the duodenum and ventral pancreas preserving subtotal pancreatectomy group
Table 5 Quality of lives after duodenum and ventral pancreas preserving subtotal pancreatectomy and total pancreatectomy
Parameters
DVPPSP(n = 8)
TP (n = 8)
P vaule
Functional scale
Physical
95.0 ± 9.3 (80-100)
97.5 ± 7.1 (80-100)
0.554
Working ability
100
100
—
Cognitive
100
100
—
Emotional
98.4 ± 2.9 (93.8-100)
92.2 ± 8.0 (75-100)
0.057
Social
95.8 ± 7.7 (83.3-100)
85.4 ± 10.7 (66.7-100)
0.042
Global QoL
96.9 ± 6.2 (83.3-100)
88.5 ± 8.9 (75-100)
0.047
Symptom scale
Fatigue
4.2 ± 8.3 (0-22.2)
11.1 ± 11.7 (0-33.3)
0.196
Nausea and vomiting
0
6.3 ± 12.4 (0-33.3)
0.197
Pain
0
0
—
Appetite loss
0
20.8 ± 24.8 (0-66.7)
0.049
Dyspnea
0
0
—
Sleep disturbance
4.2 ± 11.8 (0-33.3)
12.5 ± 17.2 (0-33.3)
0.281
Constipation
0
4.2 ± 11.8 (0-33.3)
0.351
Diarrhea
4.2 ± 11.8 (0-33.3)
12.5 ± 24.8 (0-66.7)
0.405
Financial strain
0
8.3 ± 15.4 (0-33.3)
0.170
Citation: Wang X, Tan CL, Song HY, Yao Q, Liu XB. Duodenum and ventral pancreas preserving subtotal pancreatectomy for low-grade malignant neoplasms of the pancreas: An alternative procedure to total pancreatectomy for low-grade pancreatic neoplasms. World J Gastroenterol 2017; 23(35): 6457-6466