Enucleation of Pancreatic Lesions: The Outcomes and Experiences from Two Centers

Pancreatic fistulas are the most common complication of pancreatic enucleation, which presents certain challenges. This study reported the relevant experiences of two centers regarding the reduction of clinical complications after pancreatic enucleation.

Clinical, pathologic, and follow-up data of 31 patients who underwent pancreatic enucleation at the Renmin Hospital of Wuhan University and Sinopharm Gezhouba Central Hospital between January 2019 and October 2024 were retrospectively analyzed. The occurrences of postoperative complications were observed and analyzed.

The nasopancreatic tubes were successfully placed preoperatively in 26 of the 31 patients. Injury to the main pancreatic duct was found in two cases during the operation. In eight cases, leakage with blue staining on the wound surface was detected using methylene blue injection through the nasopancreatic tube. Postoperatively, 16 cases of pancreatic fistulas were identified including 12 biochemical leaks and 4 grade B fistulas, with no grade C fistulas reported. Three patients experienced mild pancreatitis postoperatively and were cured with conservative treatment. Two patients experienced postoperative infections, one of whom also had delayed gastric emptying. No cases of bile fistula, lymphatic fistula, or perioperative death occurred. During the follow-up period, no tumor recurrence, new-onset diabetes, or dyspepsia requiring pancreatic enzyme supplementation was observed.

Enucleation is a clinically safe and feasible approach for treating benign and low-grade malignant pancreatic lesions. Preoperative placement of a nasopancreatic tube and injection of methylene blue can aid in detecting potential pancreatic leakage during surgery and offer advantages for tumors near the main pancreatic duct.