RT Journal
A1 Lillemoe KD
T1 MIddle segment pancreatectomy—invited commentary
JF Archives of Surgery
JO Archives of Surgery
YR 1998
FD March 1
VO 133
IS 3
SP 331
OP 331
DO 10.1001/archsurg.133.3.331
UL http://dx.doi.org/10.1001/archsurg.133.3.331
AB 
The perioperative results with pancreatic resection have improved dramatically during the last decade. At high-volume centers, perioperative mortality has been consistently reported to be less than 5% following pancreaticoduodenectomy. Similarly, distal pancreatectomy can be accomplished with minimal morbidity and rare mortality. Despite these improved results, a few problems remain. One such problem is that cysts and tumors arising in the midbody of the pancreas may not be optimally managed by either distal pancreatectomy or pancreaticoduodenectomy. In many cases the central location of these tumors, which are most often benign if truly candidates for resection, requires a significant extension of the resection either proximally toward the head or distally to include the tail-sacrificing normal pancreatic tissue. These extensive resections frequently result in either pancreatic exocrine or endocrine insufficiency, and with distal pancreatectomy often necessitate splenectomy.