The Research On The Application Of Middle Segmental Pancreatectomy In Pancreatic Surgery

Objective:To investigate the clinical value of the application of middle segmental pancreatectomy in pancreatic surgery.Methods:The clinical data of 19 patients after middle segmental pancreatectomy was analysed retrospectively in provincial hospital affiliated to Shandong University from Jan.2002 to Jun.2008,including:①preoperative conditions:age,gender and preoperative diagnosis;②intraoperative conditions:operative methods,intraoperative diagnosis,blood loss and transfusion volume;③postoperative condition: postoperative pathology,postoperative complications and length of stay.Incidence of pancreatic fistula after middle segmental pancreatectomy was compared with the incidence after pancreaticoduodenectomy and resection of body and tail of pancreas by chi-square test respectively,and the 19 patients were followed-up after discharge.Results:Pathological results of the 19 patients alter middle segmental pancreatectomy:9 cases were islet cell tumor,4 cases were mucinous cystoadenoma,3 cases were solid pseudopapilloma,2 cases were pancreatic carcinoid tumor,1 case was cyst-solid pseudopapilloma.All of them were pathological negative margin.Length of stay was 17.7±7.9 days(rang,10～40 days).Incidence of pancreatic fistula after middle segmental pancreatectomy was not signifisantly different from the incidence after pancreaticoduodenectomy and resection of body and tail of pancreas through chi-square test.The follow-up period was from 6 months to 6 years.All of the 19 patients were alive except 1 lost after 1.5 years.There was no reccurance or new-onset diabetes mellitus.Conclusion:Middle segmental pancreatectomy was a proper operative approach for the benign or low-malignant tumor located in the neck or body of pancreas.Middle segmental pancreatectomy may preserve endocrine and exocrine function,and decrease the risk of postoperative new-onset diabetes mellitus.Incidence of pancreatic fistula after middle segmental pancreatectomy was not signifisantly different from the incidence after pancreaticoduodenectomy and resection of body and tail of pancreas through chi-square test.The length of stay was shortened,which can save the patient's hospitalization expenses.