Laparoscopic Enucleation of Pancreatic Neoplasms: A Single-Center Experience and Outcomes

Abstract

Background:

Laparoscopic technique has been increasingly applied in the treatment of selected pancreatic tumors. The aim of this study is to evaluate the experience with laparoscopic enucleation of pancreatic neoplasms (LEPNs), for selected pancreatic diseases, at a high-volume referral center.

Methods:

Between May 2012 and October 2020, LEPNs was attempted in 16 patients with selected pancreatic neoplasms. The localization of tumors, etiology, indications, and clinical outcomes were analyzed.

Results:

Sixteen patients were included. LEPN was successfully performed in 13 patients, 3 conversions to open procedure were required. The definitive histopathological result of the resected pieces showed prevalence of intraductal papillary mucinous neoplasms. Postoperative major complications occurred for 3 patients (18.7%), the 3 of them presented postoperative pancreatic fistula (POPF). The median hospital stay was 4.5 days (range 2–7) for patients without POPF and 14.6 days (3–30) for those who presented with POPF. No deaths were registered. During a median follow-up of 43.8 months (0.2–109), no new-onset exocrine or endocrine insufficiency was diagnosed, no patient experienced tumor recurrence and, the 4 patients who underwent LEPN for insulinoma, remained asymptomatic.

Conclusion:

LEPNs has become a valuable alternative for patients with benign or low risk of malignancy tumors. Appropriate preoperative imaging is key for localization. Whenever feasible, this technique not only reduces the risks of exocrine and endocrine insufficiency, but also adds the well-known advantages of minimally invasive techniques, making it a safe and feasible treatment.