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01-06-2020 | Magnetic Resonance Cholangio Pancreatography | Dynamic Manuscript

Endoscopic placement of pancreatic stent for “Deep” pancreatic enucleations operative technique and preliminary experience at two high-volume centers

Authors: Tommaso Giuliani, Giovanni Marchegiani, Mark D. Girgis, Stefano Francesco Crinò, Venkataraman R. Muthusamy, Laura Bernardoni, Antonio Pea, Marco Ramera, Salvatore Paiella, Luca Landoni, Armando Gabbrielli, Roberto Salvia, Timothy R. Donahue, Claudio Bassi

Published in: Surgical Endoscopy | Issue 6/2020

Abstract

Background

Pancreatic enucleation (PE) is a viable option for the removal of non-malignant pancreatic masses leading to complete preservation of organ function. Nevertheless, PE is associated with substantial rates of post-operative pancreatic fistula (POPF), particularly when the mass is close to the main pancreatic duct (MPD). Preoperative stenting of the MPD may prevent its injury when performing PE. This paper describes a novel technique of “deep” PE preceded by endoscopic stenting of the MPD.

Methods

From January 2017 to May 2019, patients with small pancreatic neuroendocrine tumors proximal to the MPD were candidates for PE with previous stenting of the MPD at the University of Verona, Italy, and at the UCLA Medical Center, Los Angeles, California. The endoscopic stenting was scheduled either the day before or 3 weeks before surgery, depending on the participating institute.

Results

Ten patients were included in this pilot study. The endoscopic procedure was successful and well tolerated in all cases. Open, laparoscopic and robotic PE were performed. Seven patients had surgical complications. Among these, six developed a post-operative pancreatic fistula (POPF), but neither grade C fistulas nor disruptions of the MPD were detected. At pathology, a low grade pancreatic neuroendocrine tumor was confirmed in all cases.

Conclusion

In the setting of high-volume centers, this procedure is safe, and it is associated with acceptable short-term surgical morbidity. The preoperative stenting of the MPD might extend the surgical indications for PE.

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Title: Endoscopic placement of pancreatic stent for “Deep” pancreatic enucleations operative technique and preliminary experience at two high-volume centers
Authors: Tommaso Giuliani
Giovanni Marchegiani
Mark D. Girgis
Stefano Francesco Crinò
Venkataraman R. Muthusamy
Laura Bernardoni
Antonio Pea
Marco Ramera
Salvatore Paiella
Luca Landoni
Armando Gabbrielli
Roberto Salvia
Timothy R. Donahue
Claudio Bassi
Publication date: 01-06-2020
Publisher: Springer US
Keywords: Magnetic Resonance Cholangio Pancreatography
Insulinoma
Insulinoma
Endoscopic Retrograde Cholangiopancreatography
Published in: Surgical Endoscopy / Issue 6/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07501-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic placement of pancreatic stent for “Deep” pancreatic enucleations operative technique and preliminary experience at two high-volume centers

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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