{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:10:23Z","timestamp":1790079023764,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study compared outcomes of middle pancreatectomy (MP) and distal pancreatectomy (DP), focusing on long\u2010term glucose tolerance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 282 patients who underwent MP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200969) or DP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009213) for low\u2010grade malignant tumors from 2000 to 2020. Surgical outcomes, HbA1c levels, prevalence of diabetes mellitus (DM), and escalation of antidiabetic medication were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MP was associated with longer operation time (312 vs. 245\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and higher pancreatic fistula rate (64% vs. 47%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Among 248 patients with 3\u2010year follow\u2010up, MP showed lower HbA1c levels (5.9% vs. 6.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), lower incidence of new\u2010onset DM (3% vs. 30%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and fewer cases of increased antidiabetic medication use (8% vs. 24%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Insulin therapy was newly required in 1 MP case versus 18 DP cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite higher morbidity, MP demonstrated superior preservation of long\u2010term glucose tolerance compared with DP. These findings suggest that MP is a valuable parenchyma\u2010preserving option for patients with low\u2010grade malignant pancreatic tumors, particularly those at increased risk of postoperative DM, although careful consideration of surgical risks is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.70121","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:15:53Z","timestamp":1777004153000},"page":"712-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Middle Pancreatectomy for Low\u2010Grade Malignancies: Superior Long\u2010Term Glucose Tolerance Preservation Over Distal Pancreatectomy"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5856-9713","authenticated-orcid":false,"given":"Atsuro","family":"Fujinaga","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Esaki","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Umino","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Mizui","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nara","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.17235\/reed.2017.4291\/2016","article-title":"Central Pancreatectomy for the Treatment of a Benign Pancreatic Lesion. 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