Outcome after laparoscopic enucleation for non-functional neuroendocrine pancreatic tumours

HPB (Oxford). 2012 Mar;14(3):171-6. doi: 10.1111/j.1477-2574.2011.00422.x. Epub 2012 Jan 9.


Background: Non-functional endocrine pancreatic tumours (NPT) of more than 2 cm have an increased risk of malignancy. The aim of the present study was: (i) to define the guidelines for laparoscopic enucleation (LapEn) in patients with a non-functional NPT ≤3 cm in diameter; (ii) to evaluate pancreas-related complications; and (iii) to present the long-term outcome.

Methods: Between April 1998 and September 2010, 30 consecutive patients underwent laparoscopic surgery for a non-functional NPT (median age 56.5 years, range 44-83). Only 13 patients with tumours ≤3 cm in size underwent LapEn. Local lymph node dissection to exclude lymph node involvement was performed in all patients.

Results: The median tumour size, operative time and blood loss were 2.8 cm (range 2.8-3), 130 min (range 90-280) and 220 ml (range 120-300), respectively. A pancreatic fistula occurred in five patients: International Study Group of Pancreatic Fistula (ISGPF) A in two patients and ISGPF B in three patients. The median follow-up was 48 months (12-144). Three patients with well-differentiated carcinoma are free of disease 2, 3 and 4 years after LapEn and a regional lymphadenectomy. One patient, 5 years after a LapEn, presented with lymph node and liver metastases.

Conclusions: The present study confirms the technical feasibility and acceptable morbidity associated with LapEn. Intra-operative lymph node sampling and frozen-section examination should be performed at the time of LapEn; when a malignancy is confirmed, oncologically appropriate lymph node dissection should be performed.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cell Differentiation
  • Feasibility Studies
  • Humans
  • Laparoscopy* / adverse effects
  • Liver Neoplasms / secondary
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Middle Aged
  • Neuroendocrine Tumors / secondary
  • Neuroendocrine Tumors / surgery*
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatic Fistula / etiology
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Spain
  • Time Factors
  • Treatment Outcome
  • Tumor Burden

Supplementary concepts

  • Non functioning pancreatic endocrine tumor