Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases
Background Central pancreatectomy (CP), a partial resection of the pancreas, is indicated for the excision of neuroendocrine tumors (NETs) of the pancreas, when located at the neck or the proximal body. Specifically, CP is preferable in functional NET and in nonfunctional sized 1 to 2 cm or/with pro...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2020-10-01
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| Series: | The Surgery Journal |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718699 |
| _version_ | 1818610844819259392 |
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| author | Roza Panagis Moureletou Dimitrios Kalliouris Konstantinos Manesis Sotirios Theodoroleas Angeliki Bistaraki George Boubousis Efstathios Nikou |
| author_facet | Roza Panagis Moureletou Dimitrios Kalliouris Konstantinos Manesis Sotirios Theodoroleas Angeliki Bistaraki George Boubousis Efstathios Nikou |
| author_sort | Roza Panagis Moureletou |
| collection | DOAJ |
| description | Background Central pancreatectomy (CP), a partial resection of the pancreas, is indicated for the excision of neuroendocrine tumors (NETs) of the pancreas, when located at the neck or the proximal body. Specifically, CP is preferable in functional NET and in nonfunctional sized 1 to 2 cm or/with proliferation marker Ki67 < 20% (Grade I/II). Postoperative leakage from the remaining pancreas constitutes the most frequent complication of CP (up to 63%). The aim of our study was to share the experience of our center in CP for NET, with pancreaticojejunal anastomosis.
Methods In 1 year, we performed CP in two patients, following the aforementioned criteria. They presented with tumor of the body of the pancreas, which was found in random check with computed tomography, with negative hormonal blood tests and they underwent magnetic resonance imaging and endoscopic ultrasound/fine-needle biopsy/pathological examination.
Results The patients underwent CP with Roux-en-Y pancreaticojejunal anastomosis of the distal pancreatic stump and jejunal patch of the proximal pancreatic stump. Histological exam revealed NET sized 2.8 cm and 1.45 cm, Grade I and II, respectively. Postoperatively both patients developed small pancreatic leakage, which did not affect their physical condition and stopped after 20 and 30 days. No one needed pancreatic enzymes supplements or developed new-onset diabetes mellitus.
Conclusion CP provided adequate, functional remaining pancreatic tissue in both patients. Small leakages were treated conservatively and retreated without septic complications. As a result, CP might be considered as safe and effective technique for pancreatic neck/proximal body NET. |
| first_indexed | 2024-12-16T15:20:54Z |
| format | Article |
| id | doaj.art-f24513419c9c477fa7e400acb4cdd71a |
| institution | Directory Open Access Journal |
| issn | 2378-5128 2378-5136 |
| language | English |
| last_indexed | 2024-12-16T15:20:54Z |
| publishDate | 2020-10-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | The Surgery Journal |
| spelling | doaj.art-f24513419c9c477fa7e400acb4cdd71a2022-12-21T22:26:39ZengThieme Medical Publishers, Inc.The Surgery Journal2378-51282378-51362020-10-010604e175e17910.1055/s-0040-1718699Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two CasesRoza Panagis Moureletou0Dimitrios Kalliouris1Konstantinos Manesis2Sotirios Theodoroleas3Angeliki Bistaraki4George Boubousis5Efstathios Nikou62nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, GreeceSurgery Department, 417 Army Share Fund Hospital, Athens, Greece2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, Greece2nd Department of General Surgery, 417 Army Share Fund Hospital, Athens, GreeceBackground Central pancreatectomy (CP), a partial resection of the pancreas, is indicated for the excision of neuroendocrine tumors (NETs) of the pancreas, when located at the neck or the proximal body. Specifically, CP is preferable in functional NET and in nonfunctional sized 1 to 2 cm or/with proliferation marker Ki67 < 20% (Grade I/II). Postoperative leakage from the remaining pancreas constitutes the most frequent complication of CP (up to 63%). The aim of our study was to share the experience of our center in CP for NET, with pancreaticojejunal anastomosis. Methods In 1 year, we performed CP in two patients, following the aforementioned criteria. They presented with tumor of the body of the pancreas, which was found in random check with computed tomography, with negative hormonal blood tests and they underwent magnetic resonance imaging and endoscopic ultrasound/fine-needle biopsy/pathological examination. Results The patients underwent CP with Roux-en-Y pancreaticojejunal anastomosis of the distal pancreatic stump and jejunal patch of the proximal pancreatic stump. Histological exam revealed NET sized 2.8 cm and 1.45 cm, Grade I and II, respectively. Postoperatively both patients developed small pancreatic leakage, which did not affect their physical condition and stopped after 20 and 30 days. No one needed pancreatic enzymes supplements or developed new-onset diabetes mellitus. Conclusion CP provided adequate, functional remaining pancreatic tissue in both patients. Small leakages were treated conservatively and retreated without septic complications. As a result, CP might be considered as safe and effective technique for pancreatic neck/proximal body NET.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718699central pancreatectomypancreaticojejunal anastomosispnet |
| spellingShingle | Roza Panagis Moureletou Dimitrios Kalliouris Konstantinos Manesis Sotirios Theodoroleas Angeliki Bistaraki George Boubousis Efstathios Nikou Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases The Surgery Journal central pancreatectomy pancreaticojejunal anastomosis pnet |
| title | Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases |
| title_full | Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases |
| title_fullStr | Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases |
| title_full_unstemmed | Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases |
| title_short | Central Pancreatectomy with Roux-en-Y Pancreaticojejunal Anastomosis—Report of Two Cases |
| title_sort | central pancreatectomy with roux en y pancreaticojejunal anastomosis report of two cases |
| topic | central pancreatectomy pancreaticojejunal anastomosis pnet |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1718699 |
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