Outcome after laparoscopic enucleation for non-functional neuroendocrine pancreatic tumours

Fernández‐Cruz, Laureano; Molina, Víctor; Vallejos, Rodrigo; Chavarría, E. Jiménez; López-Boado, Miguel-Angel; Ferrer, Joana

doi:10.1111/j.1477-2574.2011.00422.x

Cited by 70 publications

(40 citation statements)

References 23 publications

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“…Their rate of IS-GPF [63] grade B or C fistula was only 4.5%, compared to 21%-23% in open series [60,64,65] . The length of stay is about 6-9 d [60,61,66] , which is shorter than 10-14 d in series with enucleation done with open technique in > 90% of the patients [64,65] .…”

Section: Laparoscopic Enucleationmentioning

confidence: 88%

“…It is a "parenchyma-sparing procedure", and its main advantages are preservation of normal pancreatic endocrine and exocrine function, avoidance of dissection or reconstruction of pancreatic or biliary duct, less blood loss and less demand for advanced laparoscopic skills [60,61] . Indication for laparoscopic enucleation is for benign or low-grade malignant tumours that can be safely removed without damaging the pancreatic or biliary duct.…”

Section: Laparoscopic Enucleationmentioning

confidence: 99%

“…Pre-operative imaging and intraoperative ultrasound assessment are crucial in ensuring that the tumour can be enucleated with negative margins and leaving the main pancreatic duct intact. In cases of non-functional neuroendocrine tumours, it is also advised to perform lymphadenectomy as these lesions can behave aggressively [61] .…”

Section: Laparoscopic Enucleationmentioning

confidence: 99%

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Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

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The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and shortterm oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons' experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. Key words: Laparoscopy; Distal pancreatectomy; Pancreaticoduodenectomy; Robotic pancreatectomy; Enucleation Core tip: This review discusses recent advances in laparoscopic distal pancreatectomy (LDP), minimally invasive pancreaticoduodenectomy (MIPD), and enucleation. Recent studies show that LDP have improved perioperative recovery and equivalent oncologic outcomes. Studies on MIPD demonstrate that it is safe in terms of intra-operative outcomes, post-operative recovery and early oncologic outcomes; however, it requires advanced laparoscopic skills. Laparoscopic enucleation has become the operation of choice for small benign tumours that are away from the main pancreatic duct, especially insulinomas. We also summarize key results in pre-operative, perioperative and post-operative outcomes from contemporary series comparing open and laparoscopic pancreatic resections in the tables.

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Section: Laparoscopic Enucleationmentioning

confidence: 88%

Section: Laparoscopic Enucleationmentioning

confidence: 99%

Section: Laparoscopic Enucleationmentioning

confidence: 99%

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Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

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“…Several studies have shown that LE is safe and feasible [7,40,41,42,43]. Patients seem to benefit from the laparoscopic technique because of a reduced endocrine and exocrine insufficiency and because of the general advantages of a smaller surgical trauma [28].…”

Section: Enucleationmentioning

confidence: 99%

Minimally Invasive Surgery for Pancreatic Disease - Current Status

et al. 2016

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Laparoscopic procedures have advanced to represent the new gold standard in many surgical fields. Although application in pancreatic surgery is hampered by the friable nature of the gland and the difficulty of its exposure, advanced technology and surgeons' experience are leading to an expansion of minimally invasive pancreatic surgery. Addressing the whole range of main operative procedures, this review analyzes the literature data so far to give an overview about the current status of minimally invasive pancreatic surgery, its indications and limitations. In acute pancreatitis, a step-up approach from percutaneous drainage to retroperitoneoscopic necrosectomy seems beneficial. Transgastric necrosectomy also preserves the retroperitoneal compartment in contrast to the laparoscopic approach, which has widely been abandoned. In tumor pathology, laparoscopic access is adequate for small benign lesions in the pancreatic tail and body. Oncological outcome shows to be at least equal to the open procedure. Concerning laparoscopic pancreaticoduodenectomy, there is no evidence for a patients' benefit currently although several studies prove that it can be done.

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“…Safety and feasibility of enucleation (EN) and middle pancreatectomy, the most common procedures performed laparoscopically, have been described (62)(63)(64).…”

Section: Parenchyma Sparing Resectionsmentioning

confidence: 99%