Distal Pancreatic Resections: Indications, Surgical Technique, and Complications

Czech version

Authors: F. Čečka; B. Jon; A. Ferko; Z. Šubrt ^*
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Hradec Králové a Lékařské fakulty UK v Hradci Králové přednosta kliniky: doc. MUDr. A. Ferko, CSc. ; Katedra válečné chirurgie, Fakulta vojenského zdravotnictví, Univerzita Obrany Brno vedoucí katedry: doc. MUDr. L. Klein, CSc. ^*
Published in: Rozhl. Chir., 2009, roč. 88, č. 7, s. 364-367.
Category: Monothematic special - Original

Overview

Introduction:
Distal pancreatic resections are relatively less frequent surgical procedures than duodenopancreatectomies. This is due to lower incidence and later onset of lesion symptoms in this part of the pancreas. The aim of our work was to evaluate retrospectively the results of distal pancreatic resections performed at the Department of Surgery, University Hospital in Hradec Králové from 1996 to 2008.

Methods:
We retrospectively evaluated the indications, surgical procedure (including complications) and the postoperative course. All procedures were done through transverse laparotomy. The pancreas was transected sharply with a scalpel and the resection line was oversewn. Staplers were not used. All the patients were given Sandostatin postoperatively.

Results:
We performed 51 distal pancreatic resections at our department from 1996 to 2008, 40 of which were distal pancreatic resections with splenectomy (78%). We performed 149 duodenopancreatectomies in the samé time period. Benign lesions or borderline lesions (chronic pancreatitis, benign tumours, borderline tumours) were found in 67% of the surgical specimens. Malignant tumours were found in 33%, most of which were adenocarcinoma. Severe pancreatic fistula developed in two patients (3.9%). Two reoperations (3.9%) were necessary due to postoperative complications. Postoperative mortality was nil.

Conclusion:
We assume that our technique resulted in a relatively low morbidity and zero mortality. However, we used this technique in all cases, and therefore cannot compare it to other techniques.

Key words:
pancreas – distal pancreatic resection – pancreatic fistula

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