PMID- 33080546
OWN - NLM
STAT- MEDLINE
DCOM- 20211008
LR  - 20211008
IS  - 1879-3320 (Electronic)
IS  - 0960-7404 (Linking)
VI  - 35
DP  - 2020 Dec
TI  - Middle-segment preserving pancreatectomy for multifocal neuroendocrine pancreatic 
      tumors.
PG  - 466-467
LID - S0960-7404(20)30412-6 [pii]
LID - 10.1016/j.suronc.2020.10.004 [doi]
AB  - BACKGROUND: Multifocal neuroendocrine tumors (NET) usually occur in the context 
      of a multiple neuroendocrine neoplasia type 1 (MEN1). When the proximal part of 
      the pancreatic body is spared by NET, Miura et al. have proposed a 
      "middle-segment preserving" pancreatectomy (MSP) as alternative to total 
      pancreatectomy [1-3]. VIDEO: A 28-year-old woman with MEN1 was referred for 
      surgical resection of a multifocal pancreatic tumor with single metastasis 
      located and a single liver metastasis in close contact with the left hepatic 
      duct. The preoperative work-up by DOTATOC-PETSCAN revealed multifocal tumors 
      sparing only the proximal part of the pancreatic body. Hormonal dosages were 
      normal but Chromogranine A was elevated at 700 mug/l. At surgery pancreatic 
      intraoperative ultrasonography confirmed the absence of tumor at the proximal 
      part of the pancreas. A pancreaticoduodenectomy was performed first followed by a 
      left pancreatectomy with partial splenectomy. A 3 x 5 cm remnant of the 
      pancreatic body vascularized by a dorsal pancreatic artery was preserved (Fig. 
      1). A left hepatectomy was then performed (Fig. 2). Digestive reconstruction is 
      performed by a pancreatojejunostomy with an externalized pancreatic stent (Fig. 
      3), hepaticojejunostomy and a gastrojejunal anastomosis. RESULTS: Surgery lasted 
      660 minutes. Postoperative course was uneventful but a late readmission was 
      necessary because of pyelonephritis due to nephrolithiasis treated by ureteral 
      stent insertion. At 11 months postoperative follow-up the patient was 
      disease-free with no endocrine dysfunction under oral pancreatic enzyme 
      supplementation. Total weight loss since surgery was 8 Kilograms. CONCLUSIONS: A 
      middle-segment-preserving pancreatectomy could be a valid surgical alternative to 
      total pancreatectomy for multifocal pancreatic tumors sparing the proximal 
      pancreatic body. This operation can achieve acceptable functional outcomes but 
      large series with long-term follow up are needed to evaluate the advantages and 
      results of MSP.
CI  - Copyright (c) 2020 Elsevier Ltd. All rights reserved.
FAU - Addeo, Pietro
AU  - Addeo P
AD  - Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies 
      Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux 
      Universitaires de Strasbourg, Universite de Strasbourg, Strasbourg, France. 
      Electronic address: pietrofrancesco.addeo@chru-strasbourg.fr.
FAU - Julliard, Olivier
AU  - Julliard O
AD  - Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies 
      Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux 
      Universitaires de Strasbourg, Universite de Strasbourg, Strasbourg, France.
FAU - Imperiale, Alessio
AU  - Imperiale A
AD  - Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, 
      France; Molecular Imaging-DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, 
      France; Faculty of Medicine, FMTS, University of Strasbourg, Strasbourg, France.
FAU - Goichot, Bernard
AU  - Goichot B
AD  - Department of Internal Medicine, Hopital de Hautepierre-Hopitaux Universitaires 
      de Strasbourg, Universite de Strasbourg, Strasbourg, France.
FAU - Bachellier, Philippe
AU  - Bachellier P
AD  - Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pole des Pathologies 
      Digestives, Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux 
      Universitaires de Strasbourg, Universite de Strasbourg, Strasbourg, France.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20201014
PL  - Netherlands
TA  - Surg Oncol
JT  - Surgical oncology
JID - 9208188
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Neuroendocrine Tumors/pathology/*surgery
MH  - Organ Sparing Treatments/*methods
MH  - Pancreatectomy/*methods
MH  - Pancreatic Neoplasms/pathology/*surgery
MH  - Prognosis
OTO - NOTNLM
OT  - Liver resection
OT  - Middle-pancreatectomy
OT  - Multifocal pancreatic tumor
EDAT- 2020/10/21 06:00
MHDA- 2021/10/09 06:00
CRDT- 2020/10/20 20:12
PHST- 2020/05/11 00:00 [received]
PHST- 2020/08/30 00:00 [revised]
PHST- 2020/10/02 00:00 [accepted]
PHST- 2020/10/21 06:00 [pubmed]
PHST- 2021/10/09 06:00 [medline]
PHST- 2020/10/20 20:12 [entrez]
AID - S0960-7404(20)30412-6 [pii]
AID - 10.1016/j.suronc.2020.10.004 [doi]
PST - ppublish
SO  - Surg Oncol. 2020 Dec;35:466-467. doi: 10.1016/j.suronc.2020.10.004. Epub 2020 Oct 
      14.