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Updated: Aug 8, 2026
Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms
Published on: April 17, 2026
Parenchyma-sparing pancreatectomy for solid pseudopapillary neoplasm of the pancreas: A propensity-matched analysis
Yecheng Xu1, Yuchen Ji1, Haojun Shi1
1Department of Pancreatic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Background:
The oncological equivalence of parenchyma-sparing pancreatectomy versus conventional resection for solid pseudopapillary neoplasm of the pancreas remains debated. This study compares perioperative and long-term outcomes between these approaches.
Materials And Methods:
A retrospective study was conducted on patients undergoing solid pseudopapillary neoplasm resection at a high-volume center between June 2002 and August 2024. Propensity score matching (1:1) balanced baseline characteristics between groups. Outcomes included morbidity, recurrence-free survival, and metabolic sequelae.
Results:
Among 261 patients, 49 (18.8%) had enucleations, 28 (10.7%) had central pancreatectomies, 2 (0.8%) had duodenum-preserving pancreatic head resections, and 182 (69.7%) underwent conventional resection. After propensity score matching, 60 pairs were analyzed. Parenchyma-sparing pancreatectomy demonstrated reduced blood loss (100 vs 200 mL, P < .001), shorter operative time (3.0 vs 5.0 hours, P < .001), and shorter hospital stay (9 vs 10.5 days, P = .008). However, parenchyma-sparing pancreatectomy had a higher overall complication rate (60.0% vs 36.7%, P = .011), driven primarily by postoperative pancreatic fistula. Long-term recurrence-free survival was equivalent between groups (P = .971), with resection type not predicting recurrence. Although not statistically significant, parenchyma-sparing pancreatectomy showed numerically lower rates of new-onset diabetes mellitus (5.2% vs 12.7%, P = .279) and pancreatic exocrine insufficiency (10.3% vs 16.4%, P = .346).
Conclusion:
Parenchyma-sparing pancreatectomy for solid pseudopapillary neoplasm offers equivalent oncological control and superior perioperative efficiency compared with conventional resection, albeit with a higher incidence of manageable postoperative pancreatic fistula. Given the potential for preserved endocrine/exocrine function, parenchyma-sparing pancreatectomy is a viable strategy for carefully selected patients when performed by experienced surgeons.
