Pancréatectomie totale pour tumeur mucineuse du pancréas

M. C. Blanchet, F. Andreelli, J. Y. Scoazec, J. Le Borgne, P. Ozoux, L. De Calan, C. Partensky

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Résumé

Aim of the study: To report our experience of total pancreatectomy (TP) in ten patients with mucinous pancreatic tumors (MPT), to discuss pre and peroperative investigations in the managment of MPT, and operative, functional and carcinologic results after TP. Patients and methods: This retrospective study from January 1985 to January 2001 included ten patients, 5 men and 5 women (mean aged: 64 years). Six patients underwent one step TP for intraductal papillary mucinous tumor of the pancreas (IPMT) in 5 cases, and multifocal mucinous cystadenoma in one case. Four patients underwent a second step TP for tumor recurrence (2 IPMT, and 2 cystadenocarcinomas) which occured 12 to 121 months post operatively (mean: 49 months). Results: Post TP diabetes was controlled by insulino-therapy (3 injections a day), except in one patient who needed insulin administration through a pump. One patient, with cystadenocarcinoma, died from cancer recurrence 18 months after TP and 140 months after the initial pancreaticoduodenectomy. One patient died from heart disease 34 months postoperatively. The 8 other patients were alive with a mean follow-up of 33 months (range 11-61 months). Conclusion: Curative surgery for mucinous tumors of the pancreas may require TP, which is indicated preoperatively according to imaging, or intraoperatively following surgical findings and frozen section of the pancreatic margin. Totalization of a previous partial pancreatectomy is mandatory in case of tumoral persistence or recurrence in the pancreatic remnant. Postoperative diabetes can be managed successfully by a specialized team.

Titre traduit de la contributionTotal pancreatectomy for mucin-producing tumor of the pancreas
langue originaleFrançais
Pages (de - à)439-448
Nombre de pages10
journalAnnales de Chirurgie
Volume127
Numéro de publication6
Les DOIs
étatPublié - 1 janv. 2002
Modification externeOui

mots-clés

  • Mucin producing tumor
  • Pancreatic tumor
  • Total pancreatectomy

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