Treatment of Middle-segment Pancreatic Benign Tumor Using Laparoscopic Central Pancreatectomy with End-to-end Pancreatic Duct Reconstruction

Benign and low-grade malignant tumors of the middle-segment pancreatic body represent a prognostically favorable subset of pancreatic neoplasms. For such tumors, the surgical approaches historically employed in clinical practice include distal pancreatectomy, middle-segment pancreatectomy followed by closure of the proximal pancreatic stump and pancreaticojejunostomy or pancreaticogastrostomy for the distal stump, local enucleation of the pancreatic tumor, or upfront pancreaticoduodenectomy. However, these historical approaches may remove excessive pancreatic tissue, alter the native pancreatic and intestinal anatomy, cause significant surgical trauma, lead to postoperative complications such as anastomotic leakage, and risk injuring the main pancreatic duct (particularly with local enucleation). This study introduces a novel surgical approach: laparoscopic central pancreatectomy (LCP) with end-to-end pancreatic duct reconstruction for mid-pancreatic tumors. This technique preserves the physiological pancreatic anatomy and restores the main pancreatic ductal continuity. Our findings demonstrate that laparoscopic central pancreatectomy with end-to-end pancreatic duct reconstruction is a safe and feasible procedure. We propose that this approach represents a promising alternative approach for middle-segment pancreatic tumor resection.