Prospects and applications of enucleation in solid pseudopapillary neoplasms of the pancreas

Abstract

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare, low-grade, malignant neoplasms that are mostly seen in young women in the second and third decades of life and are quite uncommon in children. Standard resection for benign and borderline neoplasms of the pancreas is associated with a substantial risk of postoperative morbidity and long-term functional impairment, whereas enucleation leads to less morbidity and preserves healthy parenchyma as well as exocrine and endocrine function. Enucleation of SPNs has been increasingly reported to be feasible and safe for preserving the normal physiological function of the pancreas, especially in teenagers and children. This review summarizes findings published in recent years on the enucleation of SPNs as well as potential future developments and directions. Enucleation has undoubtedly come to stay as an alternative surgical procedure for SPNs. However, many questions remain unresolved, and future directions toward the best surgical indication, the prevention and intervention of complications, especially pancreatic fistula, intraoperative resection margin safety assessment, and long-term oncology prognosis remain to be evaluated and should be explored in future clinical trials.

Complete enucleation of a complicated solid pseudopapillary neoplasm of pancreas: A case report

“…Pancreaticoduodenectomy (Whipple procedure) and distal pancreatectomy with splenectomy are performed for diseases in the head-neck and body-tail, respectively. However, enucleation is also a safe and feasible alternative for treating SPN as it preserves pancreatic physiology [ 20 ]. Also, the operative time and blood loss are lower [ 9 ].…”

Precision anatomy for minimally invasive spleen-preserving distal pancreatectomy in children: A case report of solid-pseudopapillary neoplasm in a 12-year-old girl

“…Enucleation of SPN has been increasingly reported; however, several unanswered questions remain, including its indications, risk of pancreatic leakage, how to guarantee the surgical margin, and long-term oncological outcomes [ 19 ]. In our patient, enucleation was not feasible because the tumor fully involved the pancreatic tail.…”