Middle segment pancreatectomy can be safely incorporated into a pancreatic surgeon's clinical practice

Harish Lavu, Jamie L. Knuth, Marshall S. Baker, Changyu Shen, Nicholas Zyromski, C. Schmidt, Attila Nakeeb, Thomas Howard

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Middle segment pancreatectomy (MSP) is a new operation where the advantages of parenchymal preservation are counterbalanced by a high postoperative complication rate and unease among surgeons with adopting a new technique. This study reviews our experience incorporating MSP into our clinical practice focusing on the initial 34 consecutive patients operated on by one surgeon at a single institution between 1998 and 2007. Patients were divided into early (initial 17 operations) and late (subsequent 17 operations) groups for analysis. Thirty-one reconstructions were by Roux-en-y pancreaticojejunostomy and three were by pancreaticogastrostomy. Using multiple linear regression and logistic regression, we found no significant differences in performance outcomes (operative time, blood loss, tumor size, margin negative resection rate, pancreatic fistula rate, hospital length of stay, postoperative complications, and hospital readmission rate) between our early and late experience even after adjusting for potential confounding variables (patient demographics, co-morbidities, neoplasm, pancreatitis). The pancreatic fistula rate in this series was 29.4% (10/34) and they were all International Study Group on Pancreatic Fistula (ISGPF) Grade A (60%) or B (40%). In summary, MSP is an operation with a flat learning curve and acceptable morbidity rate that can be safely incorporated as a parenchymal preserving option by pancreatic surgeons in their clinical practice.

Original languageEnglish
Pages (from-to)491-497
Number of pages7
JournalHPB
Volume10
Issue number6
DOIs
StatePublished - 2008

Fingerprint

Pancreatic Fistula
Pancreatectomy
Length of Stay
Pancreaticojejunostomy
Morbidity
Patient Readmission
Learning Curve
Confounding Factors (Epidemiology)
Operative Time
Pancreatitis
Linear Models
Neoplasms
Logistic Models
Demography
Surgeons

Keywords

  • Central pancreatectomy
  • Focal chronic pancreatitis
  • Pancreatic fistula
  • Pancreaticojejunostomy
  • Parenchymal sparing pancreatectomy

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Middle segment pancreatectomy can be safely incorporated into a pancreatic surgeon's clinical practice. / Lavu, Harish; Knuth, Jamie L.; Baker, Marshall S.; Shen, Changyu; Zyromski, Nicholas; Schmidt, C.; Nakeeb, Attila; Howard, Thomas.

In: HPB, Vol. 10, No. 6, 2008, p. 491-497.

Research output: Contribution to journalArticle

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