J.Jpn. Surg. Soc.. 83(9): 1059-1064, 1982
Report on the annual meeting
TOTAL PANCREATECTOMY WITH EN BLOC REGIONAL RESECTION AND ITS PROBLEMS
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First Department of Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan Takashi Suzuki, Atsushi Naitoh, Tomohiko Tani, Tadao Manabe, Kohtaro Uchida, Takayoshi Tobe |
There have been no 30-day postoperative deaths, and two year survival rate was 25%. This result was compared with that of Whipple operation (15 patients) and of standard total pancreatectomy (9 patients) performed on the same disease. There was, however, no significant difference in the survival rate among these three procedures. Analysis of these patients suggests that total pancreatectomy with en bloc regional resection is the most appropriate for less advanced lesions which might be resected only apparently, not actually, curatively by standard pancreatectomy or for localized lesions which mainly invade to the portal vein.
On CT, signs of fatty liver were demonstrated in five of 18 patients treated by total pancreatectomy (nine by standard procedure and nine by en bloc procedure). All of the five were those by the en bloc procedure. Meticulous vascular anastomosis after portal vein resection and satisfactory nutritional supports with enough insulin administration are recommended to prevent occurrence of fatty liver after total pancreatectomy.
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