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Invited Commentary
April 2014

Are There Really Indications for Central Pancreatectomy?

Author Affiliations
  • 1Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Surg. 2014;149(4):364. doi:10.1001/jamasurg.2013.4166

Many years after the first description of central pancreatectomy (CP), this procedure remains sporadically used.1 As Goudard et al2 describe, CP is associated with a high morbidity rate and a long postoperative hospital stay3 compared with distal pancreatectomy, the real surgical alternative. Another consideration is that the long-term effects of CP on pancreatic exocrine function are controversial. Evaluation of exocrine function is often subjective, especially without any formal fecal analysis; moreover, with a pancreaticogastrostomy, the distal remnant after CP may not contribute much to exocrine function.4 It is possible that CP could preserve long-term exocrine function by preserving the distal remnant, but no results from prospective randomized trials are available to answer this question.

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