Better preservation of endocrine function after central versus distal pancreatectomy for mid-gland lesions

Joseph Dinorcia, Leaque Ahmed, Minna K. Lee, Patrick L. Reavey, Elizabeth A. Yakaitis, James A. Lee, Beth A. Schrope, John A. Chabot, John D. Allendorf

Research output: Contribution to journalArticlepeer-review

93 Scopus citations


Background: Traditional resections for benign and low-grade malignant neoplasms of the mid pancreas result in loss of normal parenchyma that can cause pancreatic endocrine and exocrine insufficiency. Central pancreatectomy (CP) is a parenchyma-sparing option for such lesions. This study evaluates a single institution's experience with CP and compares outcomes with distal pancreatectomy (DP). Methods: We retrospectively collected data on CP patients from 1997 through 2009 and evaluated outcomes. In a subset of 50 patients, we performed a matched-pairs analysis to directly compare the short- and long-term outcomes of CP and DP. Results: Seventy-three patients underwent CP with a median operating room time of 254 minutes. Overall morbidity was 41.1% with pancreatic fistula in 20.5%. Mortality was 0%. There were no differences in fistula, morbidity, and mortality rates between the CP and DP groups. The CP group had resected for smaller lesions. CP patients had a lower rate of new-onset and worsening diabetes than DP patients (14% vs 46%; P = .003). Of new-onset and worsening diabetics, only 1 CP patient required insulin compared with 14 DP patients (P = .002). Conclusion: CP is safe and effective for select neoplasms of the mid pancreas. Patients undergoing CP have markedly decreased insulin requirements compared with DP patients.

Original languageEnglish
Pages (from-to)1247-1256
Number of pages10
Issue number6
StatePublished - Dec 2010
Externally publishedYes


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