Clinical application of limited pancreatic resection with pancreatic function preservation in benign and borderline tumors

doi:10.3877/cma.j.issn.1674-3946.2023.05.024

Abstract

Abstract:

Objective

To investigate the clinical value of restricted pancreatectomy with preservation of pancreatic function in benign and borderline tumors.

Methods

The clinical data of 86 patients with benign and borderline pancreatic tumors treated by surgery from January 2020 to September 2022 were retrospectively analyzed. They were divided into traditional group（n=52）and reserved group（n=34）according to different operation methods. Traditional group：traditional operation was performed，and reserved group：restricted pancreatectomy was performed to preserve pancreatic function. The data was processed by SPSS 22.0. Perioperative relevant indicators and postoperative quality of life measurement data were represented by（

x ¯

±s），and independent t test was performed. The statistical data of postoperative complications were represented by［n（%）］and χ² test was performed. P<0.05 was considered statistically significant.

Results

There was no significant difference in operation time，intraoperative blood transfusion，postoperative exhaust time and postoperative hospitalization time between the two groups（P>0.05）. The amount of blood loss in the retention group was significantly lower than that in the traditional group（P<0.05）. There were no significant differences in postoperative complications such as pancreatic fistula，incision infection，abdominal infection，bleeding，and gastric empting disorder between the two groups（P>0.05）. The 8 scores of postoperative quality of life in the retention group were significantly higher than those in the traditional group（P<0.05）. After a median follow-up of 16（6~38）months，there were no deaths between the two groups，and there was no significant difference in tumor recurrence（7.7% vs. 2.9%）and metastasis（3.8% vs. 2.9%）between the two groups（P>0.05）. However，the incidence of impaired internal and external pancreatic function in the preservation group was significantly lower than that in the traditional group（5.8% vs. 23.1%，P=0.035）.

Conclusion

Restricted pancreatectomy，which preserves pancreatic function，is safe and feasible in benign and borderline tumors. It preserves more normal pancreatic tissue to the maximum extent，reduces the impairment of internal and exocrine functions of the pancreas，and improves the postoperative quality of life of patients.

Key words: Benign Tumor, Borderline Tumors, Pancreatectomy, Preserve Pancreatic Function

Ming Zhang, Ji Wang, Wenxing Zhao. Clinical application of limited pancreatic resection with pancreatic function preservation in benign and borderline tumors[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(05): 562-565.

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Figures/Tables 4

References 13

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组别	例	年龄 (岁)	性别		BMI (kg/m²)		术前并发症
组别	例	年龄 (岁)	男/女		BMI (kg/m²)		有/无
传统组	52	47.7±13.8	30/22		21.5±3.2		17/35
保留组	34	48.4±12.1	16/18		22.1±2.8		10/24
t/χ²值		0.241	0.934		0.892		0.103
P值		0.405	0.334		0.187		0.749
组别	例	肿瘤直径 (cm)		ASA分级		病理类型
组别	例	肿瘤直径 (cm)		Ⅰ/Ⅱ		A/B/C/D/E
传统组	52	2.1±0.8		28/24		13/15/16/5/3
保留组	34	2.3±0.7		19/15		11/8/10/3/2
t/χ²值		1.190		0.034		0.642
P值		0.119		0.853		0.958

组别	例	年龄 (岁)	性别		BMI (kg/m²)		术前并发症
组别	例	年龄 (岁)	男/女		BMI (kg/m²)		有/无
传统组	52	47.7±13.8	30/22		21.5±3.2		17/35
保留组	34	48.4±12.1	16/18		22.1±2.8		10/24
t/χ²值		0.241	0.934		0.892		0.103
P值		0.405	0.334		0.187		0.749
组别	例	肿瘤直径 (cm)		ASA分级		病理类型
组别	例	肿瘤直径 (cm)		Ⅰ/Ⅱ		A/B/C/D/E
传统组	52	2.1±0.8		28/24		13/15/16/5/3
保留组	34	2.3±0.7		19/15		11/8/10/3/2
t/χ²值		1.190		0.034		0.642
P值		0.119		0.853		0.958

组别	例	手术时间(min)	术中出血量(ml)		术中输血情况
组别	例	手术时间(min)	术中出血量(ml)		有/无
传统组	52	231.4±41.2	263.7±69.4		3/49
保留组	34	218.9±35.4	228.1±50.7		4/30
t/χ²值		1.452	2.573		0.349
P值		0.075	0.006		0.555
组别	例	术后排气时间(d)		术后住院时间(d)
传统组	52	2.1±0.7		8.6±1.6
保留组	34	1.9±0.6		8.1±1.3
t/χ²值		1.369		1.522
P值		0.087		0.066

组别	例	手术时间(min)	术中出血量(ml)		术中输血情况
组别	例	手术时间(min)	术中出血量(ml)		有/无
传统组	52	231.4±41.2	263.7±69.4		3/49
保留组	34	218.9±35.4	228.1±50.7		4/30
t/χ²值		1.452	2.573		0.349
P值		0.075	0.006		0.555
组别	例	术后排气时间(d)		术后住院时间(d)
传统组	52	2.1±0.7		8.6±1.6
保留组	34	1.9±0.6		8.1±1.3
t/χ²值		1.369		1.522
P值		0.087		0.066

组别	例	胰瘘		切口感染
组别	例	生化瘘/B级		切口感染
传统组	52	8(15.4)/6(11.5)		4(7.7)
保留组	34	4(11.8)/3(8.8)		1(2.9)
χ²值		0.024	0.002	0.202
P值		0.876	0.967	0.653
组别	例	腹腔感染	术后出血	胃排空障碍
传统组	52	2(3.8)	1(1.9)	3(5.8)
保留组	34	1(2.9)	1(2.9)	1(2.9)
χ²值		0.142	-	0.007
P值		0.706	1.000	0.932

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