Benign tumors localized in the head, neck, or body of the pancreas are usually removed by pancreaticoduodenectomy or distal pancreatectomy, when enucleation is too risky because of possible damage of the main pancreatic duct. However, standard pancreatic resections result in an important loss of normal pancreatic parenchyma and may cause impairment of exocrine and endocrine function. If these procedures are mandatory for malignant tumors, they seem to be too extended for benign or border-line tumors, especially in young patients. In recent years, there has been a greater interest in organ-preserving pancreatic surgery with the aim of achieving better functional results without compromising oncological radicality in patients with benign, border-line or low-grade malignant tumors. Several limited resections have been introduced for isolated or multiple pancreatic lesions, depending on the location of the tumor: central pancreatectomy; duodenum-preserving pancreatic head resection with or without segmental duodenectomy; inferior head resection; dorsal pancreatectomy; excavation of the pancreatic head; middle-preserving pancreatectomy; and other multiple segmental resection, single-branch resection. All these procedures are technically feasible in experienced hands, and seem to be a safe alternative to standard pancreatic resections in the treatment of benign or border-line tumors. Although they present a morbidity rate similar or superior to that of the standard operations, they preserve long-term endocrine and exocrine pancreatic functions, resulting in a good quality of life. Careful patient selection, correct indication, and expertise in pancreatic surgery are important to achieve the best results

Organ-preserving pancreatectomy for benign or border-line neoplasms of the pancreas

SPERTI, COSIMO;PEDRAZZOLI, SERGIO;PASQUALI, CLAUDIO
2012

Abstract

Benign tumors localized in the head, neck, or body of the pancreas are usually removed by pancreaticoduodenectomy or distal pancreatectomy, when enucleation is too risky because of possible damage of the main pancreatic duct. However, standard pancreatic resections result in an important loss of normal pancreatic parenchyma and may cause impairment of exocrine and endocrine function. If these procedures are mandatory for malignant tumors, they seem to be too extended for benign or border-line tumors, especially in young patients. In recent years, there has been a greater interest in organ-preserving pancreatic surgery with the aim of achieving better functional results without compromising oncological radicality in patients with benign, border-line or low-grade malignant tumors. Several limited resections have been introduced for isolated or multiple pancreatic lesions, depending on the location of the tumor: central pancreatectomy; duodenum-preserving pancreatic head resection with or without segmental duodenectomy; inferior head resection; dorsal pancreatectomy; excavation of the pancreatic head; middle-preserving pancreatectomy; and other multiple segmental resection, single-branch resection. All these procedures are technically feasible in experienced hands, and seem to be a safe alternative to standard pancreatic resections in the treatment of benign or border-line tumors. Although they present a morbidity rate similar or superior to that of the standard operations, they preserve long-term endocrine and exocrine pancreatic functions, resulting in a good quality of life. Careful patient selection, correct indication, and expertise in pancreatic surgery are important to achieve the best results
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2523617
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