Pancreatic insufficiency after different resections for benign tumours

Br J Surg. 2008 Jan;95(1):85-91. doi: 10.1002/bjs.5652.


Background: Pancreatic resections for benign diseases may lead to long-term endocrine/exocrine impairment. The aim of this study was to compare postoperative and long-term results after different pancreatic resections for benign disease.

Methods: Between 1990 and 1999, 62 patients underwent pancreaticoduodenectomy (PD), 36 atypical resection (AR) and 64 left pancreatectomy (LP) for benign tumours. Exocrine and endocrine pancreatic function was evaluated by 72-h faecal chymotrypsin and oral glucose tolerance test.

Results: The incidence of pancreatic fistula was significantly higher after AR than after LP (11 of 36 versus seven of 64; P = 0.028). The long-term incidence of endocrine pancreatic insufficiency was significantly lower after AR than after PD (P < 0.001). Exocrine insufficiency was more common after PD (P < 0.001) and LP (P = 0.009) than after AR. The probability of developing both endocrine and exocrine insufficiency was higher for PD and LP than for AR (32, 27 and 3 per cent respectively at 1 year; 58, 29 and 3 per cent at 5 years; P < 0.001).

Conclusion: Different pancreatic resections are associated with different risks of developing long-term pancreatic insufficiency. AR represents the best option in terms of long-term endocrine and exocrine function, although it is associated with more postoperative complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chymotrypsin / analysis
  • Exocrine Pancreatic Insufficiency / etiology*
  • Exocrine Pancreatic Insufficiency / physiopathology
  • Feces / chemistry
  • Female
  • Follow-Up Studies
  • Glucose Tolerance Test
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy / adverse effects*
  • Pancreatic Neoplasms / physiopathology
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy / adverse effects*
  • Risk Factors
  • Treatment Outcome


  • Chymotrypsin