When a benign or low grade tumor is located within the neck of the pancreas,it may be amenable to a central pancreatectomy. In this procedure the middle portion of the gland is removed. The part of the pancreas towards the duodenum is over-sewn and will drain normally into the small intestine. The disconnected tail of the gland is then sewn into either the back of the stomach or the small bowel so that the digestive enzymes that are produced by that portion of pancreas can enter the lumen of the GI tract and be used for digestion. This procedure is done in an effort to spare as much of the normal pancreas as possible and reduce the risk of postoperative diabetes and pancreatic insufficiency (needing to take supplemental enzymes to properly digest food).
Risks and Considerations
A central pancreatectomy requires between 2 and 4 hours to complete. Potential complications include bleeding and infection as with the distal pancreatectomy. Patients can also leak from the new connection between the tail of the pancreas and the GI tract, making the overall complication rate a little higher than a distal pancreatectomy. However, the reduction in the rate of postoperative diabetes usually justifies the slightly higher surgical complication rate for this procedure.