Middle Pancreatectomy: Why I Rarely Do It

Excerpt

Proponents of middle pancreatectomy have presented its theoretical advantages, and Professor Bassi has done that eloquently. The principal ones are that it 1) preserves pancreatic exocrine and endocrine function, thus avoiding pancreatic exocrine insufficiency and diabetes, and 2) preserves the spleen and avoids the life-threatening complication of post splenectomy sepsis. Those who have expressed concern about the operation point out its disadvantages. The main ones are that it 1) doubles the risk of pancreatic fistula, and 2) risks the inadequate resection of malignant pancreatic tumors. In the discussion that follows, I will review each of these issues. …