Ultrasound-guided Laparoscopic Resection of Pancreatic Islet Cell Tumors

Laparoscopic vs open resection of pancreatic endocrine neoplasms: single institution’s experience over 14 years

“…Although some authors prefer preoperative magnetic resonance imaging, we use helical CT with very thin slices, intravenous contrast, and a pancreatic protocol including a rapid arterial phase [12]. Because of their small size, PENs are often not seen on preoperative imaging and are best localized with intraoperative ultrasound, which can easily be performed with minimally invasive techniques [3,[13][14][15][16]. On sonographic examination, the PENs will appear hypoechoic and are usually relatively easy to differentiate from normal pancreatic tissue [10].…”

Laparoscopic resection of the pancreas and review of the literature

“…There are 12 reports including 24 cases managed with laparoscopic enucleation [1,2,4,5,8,9,13,20,22,25,30,34]. These cases involved ranging from 95 to 270 min (mean, 175 min), operation times, estimated blood loss ranging from 0 to 1000 ml (mean, 182 ml), and lengths of hospital stays ranging from 2 to 25 days (mean, 5.7 days).…”

“…As compared with other studies, the operation times and hospital stays were relatively long and the blood loss was relatively less. The final diagnoses after laparoscopic enucleation were insulinomas in 19 cases (79.2%), normal pancreas in two cases (8.3%), and a [2,6], one case involving the need to perform pancreaticoduodenectomy for nesidioblastoma [13], and one further case involving the existence of multiple and small tumors (MEN-I) [22]. Five cases (20.8%) involved pancreatic fistulas that required reoperation [1,2,20].…”

Laparoscopic distal pancreatectomy

“…Although this technique is user dependent, few series showed it to have high accuracy. [22]. In the current series, conversion to laparotomy was required because of difficulty locating the tumor in one case.…”