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Τετάρτη 2 Δεκεμβρίου 2020

Laparoscopic enucleation of pancreatic tumours

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Laparoscopic enucleation of pancreatic tumours: a single‐institution experience of 66 cases

The main concerns of laparoscopic enucleating an embedded tumour are non‐localization of the tumour and possible injury of the main pancreatic duct. Laparoscopic enucleation for an embedded tumour is technically feasible and safe through meticulous preoperative localization, careful manoeuvres during operation and the use of a 'crushing' technique, which does not increase the conversion rate and the incidence of complications and pancreatic fistula


Abstract

Background

Laparoscopic enucleation of pancreatic tumours is seemingly a simple procedure, but challenging as the tumour is deeply embedded in the pancreatic parenchyma. Our study reports a single‐centre experience for these cases.

Methods

Cases with a tumour underwent laparoscopic enucleation from January 2014 to March 2020 in our hospital were collected and analysed.

Results

Sixty‐six cases were enrolled, including 21 men and 45 women with an average age of 43.6 ± 16.7 years old. The mean size of tumours was 2.7 ± 1.8 cm. The tumours were mainly located at the pancreatic head and neck (63.6%). The most common pathological diagnoses were insulinomas, followed by solid pseudopapillary tumours. Incidences of overall complications and pancreatic fistula (PF, Grade B) were 24.2% and 19.7%, respectively. No patient developed PF (Grade C) or died. Cases were divided into two groups according to whether the tumour was deeply embedded in the pancreas. Compared to the group with a superficial tumour (n = 36), the group with an embedded tumour (n = 30) had a longer operation time and drainage duration and a smaller tumour size (P < 0.05), but did not increase the incidence of complications and PF (Grade B/C).

Conclusion

Laparoscopic enucleation of tumours that were deeply embedded in the pancreas was technically feasible and safe.

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