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06-03-2024 | Pancreatoduodenostomy

Outcome and survival were similar with laparoscopic and open pancreatectomy in 102 solid pseudopapillary neoplasms

Authors: Tatiana Codjia, Lancelot Marique, Béatrice Aussilhou, Fadhel Samir Ftériche, Louis de Mestier, Vinciane Rebours, Jérome Cros, Philippe Ruszniewski, Philippe Lévy, Mickael Lesurtel, Alain Sauvanet, Safi Dokmak

Published in: Surgical Endoscopy | Issue 4/2024

Abstract

Background

Solid pseudopapillary neoplasms of the pancreas (SPNP) are rare tumors predominantly in young women. We report the largest single-center cohort study comparing resection of SPNP by laparoscopic approach (LA) and the open approach (OA).

Method

Between 2001 and 2021, 102 patients (84% women, median age: 30) underwent pancreatectomy for SPNP and were retrospectively studied. Demographic, perioperative, pathological, early and the long-term results were evaluated between patients operated by LA and those by OA.

Results

Population included 40 LA and 62 OA. There were no significant differences in demographics data between the groups. A preoperative biopsy by endoscopic ultrasound was performed in 45 patients (44%) with no difference between the groups. Pancreatoduodenectomy (PD) was less frequently performed by LA (25 vs 53%, p = 0.004) and distal pancreatectomy (DP) was more frequently performed by LA (40 vs 16%, p = 0.003). In the subgroup analysis by surgical procedure, LA-PD was associated with one mortality, less median blood loss (180 vs 200 ml, p = 0.034) and fewer harvested lymph nodes (11 vs 15, p = 0.02). LA-DP was associated with smaller median tumor size on imaging (40 vs 80mm, p = 0.048), shorter surgery (135 vs 190 min, p = 0.028), and fewer complications according to the median comprehensive complication index score (0 vs 8.7, p = 0.048). LA-Central pancreatectomy was associated with shorter surgery (160 vs 240, p = 0.037), less median blood loss (60 vs 200, p = 0.043), and less harvested lymph nodes (5 vs 2, p = 0.025). After a median follow-up of 60 months, two recurrences (2%) were observed and were unrelated to the approach.

Conclusions

The LA for SPNP appears to be safe, should be applied cautiously in case of PD for large lesion, and was not associated with recurrence.

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Title: Outcome and survival were similar with laparoscopic and open pancreatectomy in 102 solid pseudopapillary neoplasms
Authors: Tatiana Codjia
Lancelot Marique
Béatrice Aussilhou
Fadhel Samir Ftériche
Louis de Mestier
Vinciane Rebours
Jérome Cros
Philippe Ruszniewski
Philippe Lévy
Mickael Lesurtel
Alain Sauvanet
Safi Dokmak
Publication date: 06-03-2024
Publisher: Springer US
Keywords: Pancreatoduodenostomy
Pancreatoduodenostomy
Pancreatectomy
Published in: Surgical Endoscopy / Issue 4/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-10708-y

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Outcome and survival were similar with laparoscopic and open pancreatectomy in 102 solid pseudopapillary neoplasms

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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