Enucleation of pancreatic lesions: indications, outcomes, and risk factors for clinical pancreatic fistula

J Gastrointest Surg. 2013 Dec;17(12):2099-104. doi: 10.1007/s11605-013-2355-6. Epub 2013 Oct 8.

Abstract

Background: There are few large samples and single-center series that focus on the outcomes of pancreatic enucleation and risk factors for clinical pancreatic fistula (PF). This study aimed to evaluate the indications, short- and long-term results, and risk factors for clinical PF after pancreatic enucleation.

Methods: Patients who underwent pancreatic enucleation from January 2005 to April 2011 at the Peking Union Medical College Hospital in China were included. Clinical data were collected and analyzed.

Results: A total of 119 patients underwent enucleation. PF was the most common complication; the incidence of clinical PF (grades B and C) was 27.7 %. The most common indications were endocrine neoplasms (76.5 %). During a median follow-up of 41 months, no patient developed exocrine insufficiency. Three elderly patients developed non-insulin-dependent diabetes mellitus. One patient with VIPoma developed recurrence and liver metastasis. New York Heart Association (NYHA) class II or III (P = 0.009; hazard ratio (HR) 3.191; 95 % confidence interval (CI) 1.334-7.632), operative time ≥180 min (P = 0.025; HR 2.664; 95 % CI 1.112-6.386) were the independent risk factors for clinical PF.

Conclusion: Enucleation is a safe and effective treatment for benign and low malignant lesions of the pancreas. NYHA class II or III and operation time of ≥180 min are independent risk factors for clinical PF.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreatic Diseases / surgery*
  • Pancreatic Fistula / epidemiology
  • Pancreatic Fistula / surgery*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult