Distal pancreatectomy is not associated with increased perioperative morbidity when performed as part of a multivisceral resection.

Abstract

PURPOSE:

To evaluate the indications for and the outcomes from distal pancreatectomy.

METHODS:

Retrospective chart review of 171 patients who underwent distal pancreatectomy at Brigham and Women's Hospital between January 1996 and August 2005.

RESULTS:

Nearly one-third of distal pancreatectomies were performed as part of an en bloc resection for a contiguous or metastatic tumor. Fifty-six percent of the patients underwent a standard distal pancreatectomy +/- splenectomy (group 1), whereas 44% of distal pancreatic resections included additional organs or contiguous intraperitoneal or retroperitoneal tumor (group 2). The overall post-operative complication rate was 37%; the most common complication was pancreatic duct leak (23%). When compared to patients undergoing standard distal pancreatectomy, those with a more extensive resection including multiple viscera and/or metastatic or contiguous tumor resection had no significant difference in overall complication rate (35% v. 39%, p = 0.75), leak rate (25% v. 20%, p = 0.47), new-onset insulin-dependent diabetes mellitus (3% v. 4%, p = 1.0), and mortality (2% v. 4%, p = 0.656).

CONCLUSION:

This series includes a large number of patients in whom distal pancreatectomy was performed as part of a multivisceral resection or with en bloc resection of contiguous tumor. Complications were no different in these patients when compared to patients undergoing straightforward distal pancreatectomy.

• Authors: Jennifer L Irani, Stanley W Ashley, David C Brooks, Robert T Osteen, Chandrajit P Raut, Sara Russell, Richard S Swanson, Edward E Whang, Michael J Zinner, Thomas E Clancy
• Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) Vol. 12 Issue 12 Pg. 2177-82 (Dec 2008) ISSN: 1873-4626 [Electronic] United States
• PMID: 18677539 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Pancreatectomy (methods)
• Pancreatic Diseases (pathology, surgery)
• Postoperative Complications
• Retrospective Studies
• Treatment Outcome