胰腺实性假乳头瘤, 中段胰腺切除术, 远端胰腺切除术, 胰腺功能不全, 术后并发症

Objective To provide a basis for reasonable application of central pancreatectomy (CP) in treatment of solid pseudopapillary neoplasm of the pancreas (SPNP). Methods The clinicopathological data of patients underwent pancreatic surgery in Changhai Hospital Affiliated to Naval Military Medical University from Jan. 2010 to Dec. 2015 were retrospectively analyzed, and the cases with SPNP that located in the neck or proximal body of pancreas were retrieved. The cases were divided into CP group and the DP (distal pancreatectomy) group. Then intraoperative data and postoperative complications and recurrence rate were compared between the two groups. Results A total of 37 patients were enrolled, including 12 in CP group and 25 in DP group. There was no significant difference between the two groups in terms of operation time [(119.92± 29.56)min vs (100.92±27.91)min, t=1.902, P=0.065], blood loss [(291.67±178.16)mL vs (330.00±277.26)mL, t=-0.436, P=0.666)] or hospitalization time [(14.5±4.3)d vs (13.24±4.9)d, t=0.759, P=0.451]. There was no significant difference between the two groups in terms of pancreatic fistula, hemorrhage, abdominal infection, or delayed gastric emptying. There were differences in the incidence of new onset diabetes melitus (9.1% vs 28.6%, P=0.374) and pancreatic exocrine insufficiency (0 vs 14.3%, P=0.534) between the two groups, but there was no statistical significance (P>0.05). There was no perioperative death in either group. Conclusion Compared with DP in treatment of solid pseudopapilloma of the neck or proximal body of the pancreas, CP reduces the risk of exocrine dysfunction to a certain extent, without increasing the incidence of postoperative complications. The incidence of pancreatic fistula after CP can be effectively controlled by appropriate treatment of the stump.