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Published in:

01-10-2017

Short- and long-term outcomes of laparoscopic organ-sparing resection in pancreatic neuroendocrine tumors: a single-center experience

Authors: Javier A. Cienfuegos, Joseba Salguero, Jorge M. Núñez-Córdoba, Miguel Ruiz-Canela, Alberto Benito, Sira Ocaña, Gabriel Zozaya, Pablo Martí-Cruchaga, Fernando Pardo, José Luis Hernández-Lizoáin, Fernando Rotellar

Published in: Surgical Endoscopy | Issue 10/2017

Abstract

Background

Laparoscopic organ-sparing pancreatectomy (LOSP) is an ideal therapeutic option in selected cases of pancreatic neuroendocrine tumors (PNETs). Nevertheless, given the low frequency of PNETs, there is scarce evidence regarding short and particularly long-term outcomes of LOSP in this clinical setting.

Methods

All patients with PNETs who underwent surgery (under a LOSP policy) were retrospectively reviewed from a prospective database maintained at our center. Preoperative characteristics, operative data, pathological features and postoperative outcomes were analyzed.

Results

Between December 2003 and December 2015, 36 patients with PNETs underwent laparoscopic resections. Ten were functional tumors, 26 non-functional and 16 were “incidental” cases. The following procedures were performed: one enucleation, eight central pancreatectomies (LCP), one resection of the uncinate process and 26 distal pancreatectomies (DP) (15 of them laparoscopic vessels-preserving). There were no conversions to open surgery, and no drains were routinely left. Mean operative time was 288 min (SD 99). Hospital stay was 6 days. Eighteen patients (50%) experienced some complication of which most were mild (Clavien–Dindo I/II). Three postoperative bleedings occurred: two grade B/one grade C; two required laparoscopic reoperation. Thirteen (36.1%) patients developed peripancreatic fluid collections: two were symptomatic and were managed with transgastric drainage (one presented post-puncture abscesification requiring surgical drainage and splenectomy). Four patients (11%)—one DP and three LCP—developed new-onset pancreatogenic diabetes mellitus (NODM) in the long term. According to the European Neuroendocrine Tumor Society, 19 cases were stage I, seven IIA, two IIIA, one IIIB and seven stage IV. Over a mean follow-up of 51 months, two patients died, one due to recurrence of the tumor and another due to cirrhosis.

Conclusions

The existing different surgical options must be individually considered according to the location and particular characteristics of every tumor. Results from this single-center study document the effectiveness of LOSP in selected cases of PNETs.

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Title: Short- and long-term outcomes of laparoscopic organ-sparing resection in pancreatic neuroendocrine tumors: a single-center experience
Authors: Javier A. Cienfuegos
Joseba Salguero
Jorge M. Núñez-Córdoba
Miguel Ruiz-Canela
Alberto Benito
Sira Ocaña
Gabriel Zozaya
Pablo Martí-Cruchaga
Fernando Pardo
José Luis Hernández-Lizoáin
Fernando Rotellar
Publication date: 01-10-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5411-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Short- and long-term outcomes of laparoscopic organ-sparing resection in pancreatic neuroendocrine tumors: a single-center experience

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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