Duodenumandventralpancreaspreservingsubtotalpancreatectomyforlow-grademalignantneoplasmsofthepancreas:Analternativeproceduretototalpancreatectomyforlow-gradepancreaticneoplasms

摘要： AIMTodescribetheindications,techniqueandoutcomesofthenovelsurgicalprocedureofduodenumandventralpancreaspreservingsubtotalpancreatectomy(DVPPSP).METHODSDatacollectedretrospectivelyfrom43patientswhounderwentDVPPSPandTPbetween2009and2015inoursinglecentrewereanalysed.Forenrolment,onlypatientswithlow-gradepancreaticneoplasms,suchaspancreaticneuroendocrinetumors,intraductalpapillarymucinousneoplasms(IPMNs),andsolidpseudopapillarytumors,wereincluded.TenDVPPSP(group1)and13TP(group2)patientswereselectedinthisstudy.RESULTSTherewerenosignificantdifferencesinage,gender,comorbidities,preoperativesymptoms,AmericanSocietyofAnesthesiologistsscoreorindicationsforsurgerybetweenthetwogroups.ThemostcommonindicationwasIPMNforDVPPSPandTP(60%vs85%,P=0.411).ComparedwiththeTPgroup,theDVPPSPgrouphadcomparablepostoperativemorbidities(P=0.405)andmortalities(bothnil),butsignificantlyshorteroperativetime(232±19.6minvs335±32.3min,P<0.001).DVPPSPpreservedbetterlong-termpancreaticfunctionwithlesssupplementarytherapy(P<0.001)andbetterqualityoflife(QoL)aftersurgery,includingbetterscoresinsocial(P=0.042)andglobalhealth(P=0.047)onfunctionalscalesandlessappetiteloss(P=0.049)onthesymptomscale.CONCLUSIONDVPPSPisafeasibleandsafeprocedurethatcouldbeanalternativetoTPforlow-gradeneoplasmsarisingfromthebodyandtailregionbutacrosstheneckregionofthepancreas;DVPPSPhadbettermetabolicfunctionandQoLaftersurgery. ... （共10页）