my is a conservative surgical procedure that preserves the 1,2 the main indications for a central pancreatectomy.1,2 However, the role of a central pancreatectomy for pancreatic malignancies, such as pancreatic metastases of other neoplasms, is poorly investigated. The aim of the present study is to assess the oncological safety of central pancreatectomies for pancreatic metastases of other neoplasms, based on data reported in the literature. spleen and pancreatic parenchyma. It was proposed PF-562271 pubmed ID:http://www.ncbi.nlm.nih.gov/pubmed/19803731 as alternative to distal/extended distal pancreatectomies. The advantage of a central pancreatectomy is better preservation of both endocrine and exocrine pancreatic function, compared with a distal pancreatectomy, an extended distal pancreatectomy, and a spleen-preserving distal pancreatectomy. and non-nil mortality rates, 1,5,6 7 4 2 3 The major MATERIALS AND METHODS Patients Patients were extracted from articles identified by electronic searching in PubMed-Medline and Google Scholar and by reviewing the references of the identified articles. The searched words were “central pancreatectomy”, “medial pancreatectomy”, “median pancreatectomy”, “meso-pancreatectomy”, “middle pancreatectomy”, “segmental resection of the pancreas”, “middle segmental resection of the drawbacks of a central pancreatectomy are high morbidity particularly in aged and obese patients with diabetes. Pancreatic fistulae represent the main source of morbidity after a central pancreatectomy, being reported in up to 63% of the patients. 1 The majority of the reported central pancreatectomies worldwide were performed for a benign/low-grade malignant tumor of the mid-portion of the pancreas. 1,2 Thus, cystadenomas and pancreatic neuroendocrine tumors were Received: May 13, 2016; Revised: August 22, 2016; Accepted: September 26, 2016 Corresponding author: Traian Dumitrascu Center of General Surgery and Liver Transplant, Fundeni Clinical Institute, Fundeni Street no 258, 022328, Bucharest, Romania Tel: +40-213180417, Fax: +40-213180417, E-mail: [email protected] Copyright 2017 by The Korean Association of Hepato-Biliary-Pancreatic Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Annals of Hepato-Biliary-Pancreatic Surgery pISSN: 2508-5778eISSN: 2508-5859 Traian Dumitrascu, et al. Central pancreatectomy for metastases 77 8 9 Primary neoplasm Renal carcinoma Renal carcinoma Renal carcinoma Renal carcinoma Renal carcinoma Melanoma Melanoma Renal carcinoma Renal carcinoma Renal carcinoma Renal carcinoma Breast carcinoma Hemangiopericytoma 
Renal carcinoma Renal carcinoma Long-term outcomes Pancreatic, liver and lung recurrence at 58 months; DOD at 75 months Alive with pancreatic recurrence at 60 months Alive with no recurrence at 33 months Postoperative death due to hemorrhage Alive with no recurrence at 137 months Alive with no recurrence at 30 months Pancreatic and peritoneal recurrence at 30 months; DOD at 46 months NA Alive with no recurrence at 12 months NA NA NA NA Pancreatic recurrence at 58 months – distal spleno-pancreatectomy; alive without recurrence at 92 months Pancreatic recurrence at 59 months – distal spleno-pancreatectomy; alive without recurrence at 88 months Peritoneal recurrence at 18 months; DOD at 28 months Dumitracu, 2008, updated 13 Hirono, 2