Laparoscopic enucleation of pancreatic neoplasm

Surg Endosc. 2011 Feb;25(2):572-6. doi: 10.1007/s00464-010-1223-7. Epub 2010 Jul 10.

Abstract

Background: Enucleation is an alternative procedure for treating benign and borderline neoplasms of the pancreas, which preserves healthy parenchyma and pancreatic function. This study aimed to evaluate the postoperative and long-term results after laparoscopic enucleation.

Methods: Data collected prospectively from 23 consecutive patients who underwent laparoscopic pancreatic enucleation were analyzed.

Results: Laparoscopic enucleation was achieved successfully for 21 patients (91.3%). One death (4%) occurred. A postoperative pancreatic fistula was observed in three cases (13%), and was clinically significant in one case (4%). Enucleation was performed for endocrine neoplasm in 15 patients (65%) and for cystic neoplasm in eight patients (35%). All the patients had benign tumors at the final histopathologic diagnosis. During a median follow-up period of 53 months, no patient experienced tumor recurrence or new-onset exocrine or endocrine insufficiency.

Conclusion: Laparoscopic enucleation is a safe and effective procedure for the radical treatment of benign and borderline pancreatic tumors. The laparoscopic approach seems to be associated with a decrease in operative time, hospital stay, and pancreatic fistula after enucleation. Laparoscopy should become the standard approach in the future for enucleation of presumed benign lesions.

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Care / methods
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome