A novel laparoscopic approach to lesions related to the posterior aspect of the pancreatic head

Martínez‐Isla, Alberto; Griffith, P. Sahle; Markogiannakis, Haridimos; Clough, Rachel E.; Gandamihardja, Tasha; Qurashi, Kamran; Kekis, Panagiotis

doi:10.1016/j.amjsurg.2008.06.045

Cited by 8 publications

(3 citation statements)

References 20 publications

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“…As for the choice of surgical approach, enucleation process is recommended if tumor located on the surface of pancreas and has long distance from main pancreatic duct, if the lesion localizes deep in the body or tail of pancreas and has close relationship with main pancreatic duct, distal pancreatectomy should be performed. Laparoscopic enucleation of insulinomas in the dorsal aspect of the pancreas, or those localized deep in the pancreatic head has been reported 27, 28, however, most authors adopt an open approach in these cases. As mentioned before, it is hard to locate all lesions by preoperative imaging methods in patients with multiple or MEN‐I related insulinoma, open surgery is preferred to avoid conversion and omission of lesion(s).…”

Section: Discussionmentioning

confidence: 99%

Surgical management of patients with insulinomas: Result of 292 cases in a single institution

Zhao

Zhan

Zhang

et al. 2010

Journal of Surgical Oncology

128

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Surgery is the best treatment of choice for insulinoma patients. Surgical approach depends on tumor size, location, and its pathological characters. Laparoscopic management of insulinomas is feasible and safe for tumors located in the body or tail of the pancreas. Open surgery combined with intraoperative ultrasonography is recommended to avoid omission of lesions in patients with multiple insulinomas. An aggressive surgical approach is indicated for malignant insulinoma patients.

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Section: Discussionmentioning

confidence: 99%

Surgical management of patients with insulinomas: Result of 292 cases in a single institution

Zhao

Zhan

Zhang

et al. 2010

Journal of Surgical Oncology

128

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“…The main focus of surveys on I-GO-MIPS (a minimally invasive pancreatic surgery), according to Zerbi et al, is to analyze the volume, type, and surgical indications for minimally invasive pancreatic surgery to assess the postoperative outcomes and increase the use of MIPS in Italian centers and to contribute to the European registry [33,34]. In the last two decades, the rate of pNET surgery has been improved, especially regarding minimally invasive distal pancreatic surgery on the pancreatic body and tail [35,36]. The current preference of parenchyma-sparing techniques such as enucleation and middle pancreatectomy (for lesions of the central portion of the gland) arises from the high risk of pancreatic endocrine/exocrine insufficiency following PD and DP [37].…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?

Patrone,

Mongardini,

Conzo

et al. 2024

JCM

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Background: Pancreatic neuroendocrine tumors (pNETs) represent a rare subset of pancreatic cancer. Functional tumors cause hormonal changes and clinical syndromes, while non-functional ones are often diagnosed late. Surgical management needs multidisciplinary planning, involving enucleation, distal pancreatectomy with or without spleen preservation, central pancreatectomy, pancreaticoduodenectomy or total pancreatectomy. Minimally invasive approaches have increased in the last decade compared to the open technique. The aim of this study was to analyze the current diagnostic and surgical trends for pNETs, to identify better interventions and their outcomes. Methods: The study adhered to the PRISMA guidelines, conducting a systematic review of the literature from May 2008 to March 2022 across multiple databases. Several combinations of keywords were used (“NET”, “pancreatic”, “surgery”, “laparoscopic”, “minimally invasive”, “robotic”, “enucleation”, “parenchyma sparing”) and relevant article references were manually checked. The manuscript quality was evaluated. Results: The study screened 3867 manuscripts and twelve studies were selected, primarily from Italy, the United States, and China. A total of 7767 surgically treated patients were collected from 160 included centers. The mean age was 56.3 y.o. Enucleation (EN) and distal pancreatectomy (DP) were the most commonly performed surgeries and represented 43.4% and 38.6% of the total interventions, respectively. Pancreatic fistulae, postoperative bleeding, re-operation, and follow-up were recorded and analyzed. Conclusions: Enucleation shows better postoperative outcomes and lower mortality rates compared to pancreaticoduodenectomy (PD) or distal pancreatectomy (DP), despite the similar risks of postoperative pancreatic fistulae (POPF). DP is preferred over enucleation for the pancreas body–tail, while laparoscopic enucleation is better for head pNETs.

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“…The main focus of survey I-GO-MIPS (mininvasive pancreatic surgery), according to Zerbi et al is to analyze the volume, type, and surgical indication for mininvasive pancreatic surgery to rate postoperative outcomes and increase the use of MIPS in Italian centers and to contribute to the European registry [34,35]. In the last two decades the rate of pNETs surgery is improved especially mininvasive distal pancreatic surgery on pancreatic body and tail [36,37]. Current preference of parenchyma-sparing techniques such as enucleation and middle pancreatectomy (for lesions of the central portion of the gland) arises from the high risk of pancreatic endocrine/exocrine insufficiency following PD and DP [38].…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?

Patrone,

Mongardini,

Conzo

et al. 2024

Preprint

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Background: Pancreatic neuroendocrine tumors (pNETs) represents a rare subset of pancreatic cancer. Functional tumors caused hormonal changes and clinical syndromes, while non-functional ones are often diagnosed late. Surgical management need a multidisciplinary planning, involving enucleation, distal pancreatectomy with or without spleen preserving, cen-tral pancreatectomy, pancreaticoduodectomy or total pancreatectomy. Minimally invasive ap-proach increased in the last decade compared to the open technique. The aim of this study is to analyze current diagnostic and surgical trends for pNETs, to identify better interventions and their outcomes. Methods: The study adhered to PRISMA guidelines, conducting a systematic review of literature from May 2008 to March 2022 across multiple databases. Several combinations of keywords was used ("NET", "pancreatic", "surgery", "laparoscopic", "minimally invasive", "robotic”, “enuclea-tion”,“parenchima sparing”) and relevant article references was manually checked. Manuscript quality was evaluated. Results: The study screened 3867 manuscripts, twelve studies were selected, primarily from Ita-ly, the United States, and China. A total of 7767 surgical treated patients was collected from 160 included centers. The mean age was 56,3 y.o. Enucleations (EN) and distal pancreatectomy (DP) was the most common performed surgery and represents 43.4% and 38.6% of the total interven-tions, respectively. Pancreatic fistula, post operative bleeding, re-operation and follow up was recorded and analyzed. Conclusions: Enucleation show better postoperative outcomes and lower mortality rates com-pared to pancreaticoduodenectomy (PD) or distal pancreatectomy (DP), despite similar risks of postoperative pancreatic fistula (POPF). DP was preferred over enucleation for pancreas body-tail, while laparoscopic enucleation is better for head pNETs.

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A novel laparoscopic approach to lesions related to the posterior aspect of the pancreatic head

Cited by 8 publications

References 20 publications

Surgical management of patients with insulinomas: Result of 292 cases in a single institution

Surgical management of patients with insulinomas: Result of 292 cases in a single institution

Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?

Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?

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