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Neuroendocrine tumors of the pancreas
Y Van Nieuwenhove1, S Vandaele, B Op de Beeck
1Department of Abdominal Surgery, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium. hlkvney@az.vub.ac.be
Background:
The benefits of associating magnetic resonance imaging (MRI) and laparoscopy for localizing and treating neuroendocrine pancreatic tumors (NEPTs) have been poorly documented.
Methods:
In a retrospective study, eight patients with a mean age of 48 years were operated on for a NEPT. MRI was used to localize the lesions. In all patients a laparoscopic resection was carried out. Laparoscopic ultrasonography (LUS) was used during most operations.
Results:
The tumor was clearly localized by MRI in seven patients, and LUS showed the lesion in another patient whose preoperative MRI had been unsuitable. Three enucleations, three spleen-preserving caudal pancreatectomies, and two caudal pancreatectomies with splenectomy were carried out. There were no conversions and the mean operating time was 260 min, with a mean blood loss of 180 ml. The mean hospital stay was 7 days. There were no minor nor major complications during the hospitalization period. However, a pancreatic abscess was diagnosed in one patient 1 month later, requiring an urgent laparotomy.
Conclusion:
MRI as well as LUS are indeed suitable techniques to localize NEPTs. Moreover, the minimally invasive approach ensured an adequate treatment with a more comfortable and short postoperative recovery.