Central pancreatectomy:An uncommon but potentially optimal choice of pancreatic resection  

作　　者：Dimitrios Oikonomou Ricky H Bhogal Vasileios K Mavroeidis 

机构地区：[1]Department of HPB Surgery,King’s College Hospital,Denmark Hill,London,SE59RS,UK [2]Department of Academic Surgery,The Royal Marsden NHS Foundation Trust,Fulham Road,Chelsea,London SW36JJ,UK [3]Department of HPB Surgery,University Hospitals Bristol and Weston NHS Foundation Trust,Bristol Royal Infirmary,Upper Maudlin St,Bristol BS28HW,UK

出　　处：《Hepatobiliary & Pancreatic Diseases International》2025年第2期119-127,共9页国际肝胆胰疾病杂志(英文版)

摘　　要：Benign,premalignant or low-grade malignant pancreatic tumors are increasingly diagnosed owing to the widespread uptake of cross-sectional imaging.Surgical excision is a potential treatment option for these tumors.Pancreatoduodenectomy and distal pancreatectomy are the standard resections for tumors located in the pancreatic head-neck or body-tail,respectively,and not uncommonly sacrifice a significant amount of healthy pancreatic parenchyma.Central pancreatectomy(CP)is a parenchyma-sparing procedure,initially performed by Dagradi and Serio in 1982,in a patient with pancreatic neck insulinoma.Since then,an increasing number of cases are being performed worldwide,either via open or minimally invasive surgical access.Additionally,pancreatic enucleation is reserved for tumors<3 cm,without involvement of the main pancreatic duct.CP remains an alternative approach in selected cases,albeit in the presence of some controversies,such as its use in early pancreatic ductal adenocarcinoma or metastatic deposits to the central aspect of the pancreas from other malignancies.In recent years,clarity is lacking as regards indications for CP,and despite accumulating evidence in favor of limited resections for suitable pancreatic tumors,no evidence-based consensus guidelines are yet available.Nevertheless,it appears that appropriate patient selection is of paramount importance to maximize the advantages of preservation of endocrine and exocrine pancreatic functions as well as to mitigate the risks of higher complication rates.In this comprehensive review,we explore the role of CP in the treatment of lesions located in the neck and proximal body of the pancreas.

关 键 词：Central/middle/median pancreatectomy PANCREATODUODENECTOMY Distal pancreatectomy Pancreatic tumors Exocrine/endocrine pancreatic function Type 3c pancreatogenic diabetes mellitus 

分 类 号：R657.5[医药卫生—外科学]