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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Left-sided pancreatic incidentalomas treated with laparoscopic approach: a report of 20 cases

Authors: Marco Chiarelli, Martino Gerosa, Fulvio Tagliabue, Luca Fumagalli, Angelo Guttadauro, Francesco Gabrielli, Alessandro Marando, Matilde De Simone, Ugo Cioffi

Published in: World Journal of Surgical Oncology | Issue 1/2016

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Abstract

Background

The diffusion of cross-sectional imaging has recently permitted the detection of an increasing number of incidentalomas localized in the distal pancreas.
Currently, there are no studies in the literature exploring the laparoscopic approach as treatment for left-sided pancreatic incidentalomas.

Methods and results

We report a series of 20 incidentalomas localized in the body and tail of the pancreas treated with laparoscopic surgery over the period 2010–2014. The incidental masses of our series included a great variety of histotypes and a relevant proportion of malignant lesions. In two cases, the laparoscopic procedures were converted to open surgery. No postoperative death was observed. The postoperative pancreatic fistula rate was 20 %, and the new-onset diabetes rate was 25 %.

Conclusions

Left-sided pancreatic incidentalomas in patients with minor comorbidities can be safely treated with laparoscopic approach. Only clinical trials will confirm whether laparoscopic surgery is an effective treatment for malignant lesions.
Literature
1.
Zarate X, Williams N, Herrera MF. Pancreatic incidentalomas. Best Pract Res Clinical Endocrinol Metab. 2012;26:97–103.CrossRef
2.
Berland LL, Silverman SG, Gore RM, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol. 2010;7:754–73.CrossRefPubMed
3.
Fitzgerald TL, Smith AJ, Ryan M, et al. Surgical treatment of incidentally identified pancreatic masses. Can J Surg. 2003;46:413–8.PubMedPubMedCentral
4.
Winter JM, Cameron JL, Lillemoe KD, et al. Periampullary and pancreatic incidentaloma. A single institution’s experience with an increasingly common diagnosis. Ann Surg. 2006;243:673–80.CrossRefPubMedPubMedCentral
5.
Bruzoni M, Johnston E, Sasson AR. Pancreatic incidentalomas: clinical and pathologic spectrum. Am J Surg. 2008;195:329–32.CrossRefPubMed
6.
Sachs T, Pratt WB, Callery MP, et al. The incidental asymptomatic pancreatic lesion: nuisance or threat? J Gastrointest Surg. 2009;13:405–15.CrossRefPubMed
7.
Lahat G, Ben Haim M, Nachmany I, et al. Pancreatic incidentalomas: high rate of potentially malignant tumors. J Am Coll Surg. 2009;209:313–9.CrossRefPubMed
8.
Borja-Cacho D, Al-Refaie WB, Vickers SM, et al. Laparoscopic distal pancreatectomy. J Am Coll Surg. 2009;209:758–65.CrossRefPubMed
9.
Jin T, Altaf K, Xiong JJ, et al. A systematic review and meta-analysis of studies comparing laparoscopic and open distal pancreatectomy. HPB. 2012;14:711–24.CrossRefPubMedPubMedCentral
10.
Venkat R, Edil BH, Schulick RD, et al. Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: a systematic review and meta-analysis. Ann Surg. 2012;255:1048–59.CrossRefPubMed
11.
Sulpice L, Farges O, Goutte N, et al. Laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: time for a randomized controlled trial? Results of an all-inclusive national observational study. Ann Surg. 2015;262:868–74.CrossRefPubMed
12.
Balzano G, Zerbi A, Capretti G, et al. Effect of hospital volume on outcome of pancreaticoduodenectomy in Italy. Br J Surg. 2008;95:357–62.CrossRefPubMed
13.
Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) group. Surgery. 2005;138:8–13.CrossRefPubMed
14.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;35:S64–71.CrossRef
15.
Patterson EJ, Gagner M, Salky B, et al. Laparoscopic pancreatic resection: single-institution experience of 19 patients. J Am Coll Surg. 2001;193:281–7.CrossRefPubMed
16.
Sener SF, Fremgen A, Menk HR, et al. Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database. J Am Coll Surg. 1999;189:1–7.CrossRefPubMed
17.
Crippa S, Fernandez-Del Castillo C, Salvia R, et al. Mucin-producing neoplasms of the pancreas: an analysis of distinguishing clinical and epidemiologic characteristics. Clin Gastroenterol Hepatol. 2010;8:213–9.CrossRefPubMed
18.
Zerbi A, Falconi M, Rindi G, et al. Clinicopathological features of pancreatic endocrine tumors: a prospective multicenter study in Italy of 297 sporadic cases. Am J Gastroenterol. 2010;105:1421–9.CrossRefPubMed
19.
De la Fuente SG, Ceppa EP, Reddy SK, et al. Incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA). J Gastrointest Surg. 2010;14:1139–42.CrossRefPubMed
20.
Sheehan M, Latona C, Araha G, et al. The increasing problem of unusual pancreatic tumors. Arch Surg. 2000;135:644–8.CrossRefPubMed
21.
Clarke DL, Thomson SR, Madiba TE, et al. Preoperative imaging of pancreatic cancer: a management-oriented approach. J Am Coll Surg. 2003;196:119–29.CrossRefPubMed
22.
Low G, Panu A, Millo N, et al. Multimodality imaging of neoplastic and nonneoplastic solid lesions of the pancreas. Radiographics. 2011;31:993–1015.CrossRefPubMed
23.
Buerke B, Domagk D, Heindel W, et al. Diagnostic and radiological management of cystic pancreatic lesions: important features for radiologists. Clin Radiol. 2012;67:727–37.CrossRefPubMed
24.
Kocher KE, Meurer WJ, Fazel R, et al. National trends in use of computed tomography in the emergency department. Ann Emerg Med. 2011;58:452–62.CrossRefPubMed
25.
Italian Association of Hospital Gastroenterologists and Endoscopists; Italian Association for the Study of the Pancreas, Buscarini E, Pezzilli R, Cannizzaro R, et al. Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms. Dig Liver Dis. 2014;46:479–93.CrossRef
26.
Petrone MC, Arcidiacono PG. Role of endoscopic ultrasound in the diagnosis of cystic tumours of the pancreas. Dig Liver Dis. 2008;40:847–53.CrossRefPubMed
27.
Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. Am J Gastroenetrol. 2007;102:2339–49.CrossRef
28.
Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, et al. Primary pancreatic cystic neoplasms revisited. Part I: serous cystic neoplasms. Surg Oncol. 2011;20:e84–92.CrossRefPubMed
29.
Tanaka M, Fernandez-del Castillo C, Adsay V, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12:183–97.CrossRefPubMed
30.
Natan H, Cameron JL, Goodwin CR, et al. Risk factors for pancreatic leak after distal pancreatectomy. Ann Surg. 2009;250:277–81.CrossRef
31.
Shirakawa S, Matsumoto I, Toyama H, et al. Pancreatic volumetric assessment as a predictor of new-onset diabetes following distal pancreatectomy. J Gastrointest Surg. 2012;16:2212–9.CrossRefPubMedPubMedCentral
Metadata
Title
Left-sided pancreatic incidentalomas treated with laparoscopic approach: a report of 20 cases
Authors
Marco Chiarelli
Martino Gerosa
Fulvio Tagliabue
Luca Fumagalli
Angelo Guttadauro
Francesco Gabrielli
Alessandro Marando
Matilde De Simone
Ugo Cioffi
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0949-7

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