Middle-preserving pancreatectomy for multicentric body-sparing lesions of the pancreas

BackgroundThe appropriate surgical approach of a pancreatic multifocal disease that skips the body of the gland remains unknown. We sought to analyze a parenchyma-sparing surgical technique consisting of a middle-preserving pancreatectomy (MPP) evaluating feasibility, safety, and oncological and functional outcomes.Patients and methodsBetween 1999 and 2007, 5 patients affected by pancreatic benign or slow malignant multicentric body-sparing disease underwent MPP.ResultsThere were 3 men and 2 women with a median age of 35 years (range 28–70 years). The median operative time was 365 minutes (range 330–440 minutes). Postoperative mortality was nil and postoperative morbidity was 1 (20%). At a median follow-up of 20 months (range 14–118 months) all of the patients are alive and disease-free. Overall, 2 patients developed insulin-dependent diabetes mellitus, as well as exocrine insufficiency. One patient developed only exocrine insufficiency.ConclusionsMPP is a feasible procedure and might reduce the risk of both endocrine and exocrine insufficiency.