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01-09-2016 | Original Article

Parenchyma-sparing surgery for pancreatic endocrine tumors

Authors: Fara Uccelli, F. Gavazzi, G. Capretti, M. Virdis, M. Montorsi, A. Zerbi

Published in: Updates in Surgery | Issue 3/2016

Abstract

Enucleation (EN) and middle pancreatectomy (MP) have been proposed as a treatment for G1 and G2 pancreatic neuroendocrine tumors (PNET). The aim of this study is to analyze the outcomes of parenchyma-sparing surgery (PSS) for PNET in an Italian high-volume center. All patients with a histological diagnosis of PNET who underwent surgical resection in our center between January 2010 and January 2016 were included in the study. Demographic, perioperative, and discharge data were collected in a prospective database. Follow-up was considered until March 31, 2016. 99 patients were included. PSS was performed in 22 cases (22.2 %), 18 EN (82 %), and 4 MP (18 %). 89.8 % patients were staged with CT scan, 69.6 % with endoscopic ultrasonography, 48.4 % with MRI, and 47.4 % with 68Ga-PET. Pre-operative histological diagnosis was obtained in 68.6 %. Most of PSS tumors were G1 (n = 15; 68 %) and there were no G3. Nodal sampling was performed in every PSS. Only two patients showed nodal metastatic disease. The median post-operative length of stay was 7 days after PSS. Eleven (50 %) of these patients developed a complication; two (18.2 %) were major complications. Pancreatic fistula developed in ten patients (45.5 %); two (20 %) were type B. There were no type C fistula and no re-operations after PSS. Readmission rate was 9 %. All patients submitted to PSS are alive and free of recurrence. PSS is a safe technique for G1 and G2 PNETs, but it has to be conducted in experienced centers and an extensive nodal sampling and a long follow-up are required for the best oncologic outcome.

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Title: Parenchyma-sparing surgery for pancreatic endocrine tumors
Authors: Fara Uccelli
F. Gavazzi
G. Capretti
M. Virdis
M. Montorsi
A. Zerbi
Publication date: 01-09-2016
Publisher: Springer Milan
Published in: Updates in Surgery / Issue 3/2016
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-016-0400-1

At a glance: The STEP trials

Springer Medicine

Parenchyma-sparing surgery for pancreatic endocrine tumors

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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