Laparoscopic enucleation of pancreatic neoplasm.

Surg Endosc

Service de Chirurgie Digestive et Endocrinienne, CHU Bordeaux, Hopital Haut Lévéque, Avenue Magellan, 33604, PESSAC Cedex, France.

Published: February 2011

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.

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http://dx.doi.org/10.1007/s00464-010-1223-7DOI Listing

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