Short- and long-term outcomes of laparoscopic organ-sparing resection for pancreatic neuroendocrine neoplasms

Abstract

BackgroundPancreatic neuroendocrine neoplasms (PNENs) are rare neoplasm with long life expectancy. In this setting, patients may benefit from laparoscopic organ-sparing resection. There are few reports of laparoscopic organ-sparing resection for PNENs. The aim of this study was to evaluate the Short- and long-term outcomes of laparoscopic organ-sparing resection for PNENs.MethodsA retrospective study was performed for patients with PNENs who underwent laparoscopic organ-sparing pancreatectomy between March 2005 and May 2018. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data (including pancreatic function, till August 2018) was analyzed.ResultsThirty-five patients were identified. There were 9 male and 26 female patients, with a median age of 46 years (range, 25-75 years). The mean BMI was 24.6±3.3kg/m2. Nine patients received laparoscopic enucleation, 20 received laparoscopic spleen-preserving distal pancreatectomy, and 6 received laparoscopic central pancreatectomy. The operative time, intraoperative blood loss, transfusion rate, postoperative hospital stay were 186.4±60.2min, 165±73.0ml, 0, 9d(range, 5-23d), respectively. The morbidity rate, ≥Grade Ⅲ complication rate and ≥grade B pancreatic fistula rate were 34.2%, 11.4%, 8.7%, respectively, with no mortality. The rate of follow-up was 94.3%, and the median follow-up time was 55 months (range, 3-158months). One patients had diabetes after laparoscopic spleen-preserving distal pancreatectomy, no patient had symptom of pancreatic exocrine insufficiency. One patient developed recurrence 36 months after laparoscopic enucleation and was managed with surgical resection. The other patients survived without metastases or recurrence during the follow-up.ConclusionsLaparoscopic organ-sparing resection for selected cases of PNENs is safe and feasible, and have favorable short- and long-term outcome.