Central Resection

Sergio Pedrazzoli, Claudio Pasquali, Cosimo Sperti Introduction

In 1959, Letton and Wilson reported the first non-resective treatment of traumatic rupture of the neck of the pancreas. The right stump of the pancreatic head was oversewn, and a Roux-en-Y loop of jejunum was anastomosed to the left body/tail of the pancreas. In 1984, Dagradi and Serio reported the first central pancreatectomy for an insulinoma, and in 1988, Fagniez, Kracht, and Rotman reported two central pancreatectomies performed for an insulinoma and a serous cystadenoma. At least 150 central pancreatectomies have been reported so far without mortality. Central pancreatectomy involves anatomic removal of benign or borderline lesions of the neck and/or proximal body of the pancreas together with 1 cm of normal tissue on both sides. The goal is to preserve at least 5 cm of the normal pancreatic tissue of the body/tail of the pancreas that would otherwise be removed with a complete left pancreatectomy.

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