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Application of Mid-Pancreatectomy with End-to-End Anastomosis in Pancreatic Benign Tumors
Published on: February 9, 2024
Parenchyma-preserving resections for small nonfunctioning pancreatic endocrine tumors
Massimo Falconi1, Alessandro Zerbi, Stefano Crippa
1Chirurgia Generale B (Pancreas Unit), Department of Surgery, University of Verona, Policlinico GB Rossi, Verona, Italy. massimo.falconi@univr.it
Annals of Surgical Oncology
|February 18, 2010
Summary
Parenchyma-preserving resections (PPRs) are safe for small nonfunctioning pancreatic endocrine tumors (NF-PETs). Routine lymph node sampling and long-term follow-up are crucial for optimal patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endocrinology
Background:
- Parenchyma-preserving resections (PPRs) like enucleation and middle pancreatectomy (MP) are standard for insulinomas.
- Their application in nonfunctioning pancreatic endocrine tumors (NF-PETs) remains debated.
Purpose of the Study:
- To evaluate perioperative and long-term outcomes of PPRs for NF-PETs.
- To assess the safety and efficacy of these organ-sparing techniques.
Main Methods:
- Retrospective analysis of patients undergoing PPRs for NF-PETs (1990-2005).
- Exclusion of patients with multiple endocrine neoplasia type 1.
- Data collection on perioperative complications, pathology, and long-term follow-up.
Main Results:
- 50 patients underwent 26 enucleations and 24 MP; 58% of NF-PETs were incidental.
- Morbidity and pancreatic fistula rates were 58% and 50%, respectively; MP group had higher complications.
- 8% experienced recurrence after a median follow-up of 58 months; 8% developed insufficiency.
Conclusions:
- PPRs are generally safe and effective for small NF-PETs.
- Improved selection criteria and routine lymph node sampling are needed to prevent understaging.
- Long-term follow-up is essential due to the risk of late recurrences.
