[Enucleation of pancreatic tumors: a multiple-center study]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endocrinology

Background:

• Pancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of neoplasms.
• Surgical management of pNETs aims for complete tumor removal while minimizing morbidity.
• Enucleation is a conservative surgical approach for selected pNETs.

Purpose of the Study:

• To evaluate the immediate outcomes of enucleation for pancreatic neuroendocrine tumors (pNETs).
• To compare enucleation with other surgical techniques for pNETs.
• To identify factors influencing postoperative complications after pNET surgery.

Main Methods:

• Retrospective analysis of 95 patients who underwent enucleation for pNETs between 2016 and 2021.
• Comparison with 167 patients who underwent other resections for pNETs during the same period.
• Analysis of tumor characteristics (functioning vs. non-functioning, size, location) and surgical approach (traditional vs. minimally invasive).

Main Results:

• Enucleation was performed in 36.2% of 262 pNET patients.
• Pancreatic fistula occurred in 21% of patients undergoing traditional surgery, with a higher incidence in intraparenchymal tumors (OR 5.26, p=0.0041).
• Postoperative mortality was 2.1%.

Conclusions:

• Enucleation is recommended for highly differentiated pNETs up to 2 cm.
• Minimally invasive enucleation is suitable for extraorganic pNETs.
• Intraparenchymal location significantly increases the risk of postoperative complications.