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Outcome and survival were similar with laparoscopic and open pancreatectomy in 102 solid pseudopapillary neoplasms

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Abstract

Background

Solid pseudopapillary neoplasms of the pancreas (SPNP) are rare tumors predominantly in young women. We report the largest single-center cohort study comparing resection of SPNP by laparoscopic approach (LA) and the open approach (OA).

Method

Between 2001 and 2021, 102 patients (84% women, median age: 30) underwent pancreatectomy for SPNP and were retrospectively studied. Demographic, perioperative, pathological, early and the long-term results were evaluated between patients operated by LA and those by OA.

Results

Population included 40 LA and 62 OA. There were no significant differences in demographics data between the groups. A preoperative biopsy by endoscopic ultrasound was performed in 45 patients (44%) with no difference between the groups. Pancreatoduodenectomy (PD) was less frequently performed by LA (25 vs 53%, p = 0.004) and distal pancreatectomy (DP) was more frequently performed by LA (40 vs 16%, p = 0.003). In the subgroup analysis by surgical procedure, LA-PD was associated with one mortality, less median blood loss (180 vs 200 ml, p = 0.034) and fewer harvested lymph nodes (11 vs 15, p = 0.02). LA-DP was associated with smaller median tumor size on imaging (40 vs 80mm, p = 0.048), shorter surgery (135 vs 190 min, p = 0.028), and fewer complications according to the median comprehensive complication index score (0 vs 8.7, p = 0.048). LA-Central pancreatectomy was associated with shorter surgery (160 vs 240, p = 0.037), less median blood loss (60 vs 200, p = 0.043), and less harvested lymph nodes (5 vs 2, p = 0.025). After a median follow-up of 60 months, two recurrences (2%) were observed and were unrelated to the approach.

Conclusions

The LA for SPNP appears to be safe, should be applied cautiously in case of PD for large lesion, and was not associated with recurrence.

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References

  1. Law JK, Ahmed A, Singh VK, Akshintala VS, Olson MT, Raman SP et al (2014) A systematic review of solid-pseudopapillary neoplasms: are these rare lesions? Pancreas 43(3):331–337

    Article  PubMed  PubMed Central  Google Scholar 

  2. World Health Organization, International Agency for Research on Cancer (2000) Pathology and genetics of tumours of the digestive system. In: Aaltonen LA, Hamilton SR (eds). IARC Press, Lyon

    Google Scholar 

  3. Frantz VK (1959) Atlas of tumor pathology, 7th section, 27–28th fascicles. US Armed Forces Institute of Pathology, Washington. Available from: https://scholar.google.com/scholar_lookup?title=Atlas+of+tumor+pathology,+7th+section,+27%E2%80%9328th+fascicles&author=VK+Frantz&publication_year=1959. Accessed 22 July 2021

  4. Papavramidis T, Papavramidis S (2005) Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. J Am Coll Surg 200(6):965–972

    Article  PubMed  Google Scholar 

  5. Lima CA, Silva A, Alves C, Alves A, Lima S, Cardoso E et al (2017) Solid pseudopapillary tumor of the pancreas: clinical features, diagnosis and treatment. Rev Assoc Med Bras 63(3):219–223

    Article  PubMed  Google Scholar 

  6. Palanivelu C, Senthilnathan P, Sabnis SC, Babu NS, Srivatsan Gurumurthy S, Anand Vijai N et al (2017) Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. Br J Surg 104(11):1443–1450

    Article  CAS  PubMed  Google Scholar 

  7. Venkat R, Edil BH, Schulick RD, Lidor AO, Makary MA, Wolfgang CL (2012) Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: a systematic review and meta-analysis. Ann Surg 255(6):1048–1059

    Article  PubMed  Google Scholar 

  8. de Rooij T, Jilesen AP, Boerma D, Bonsing BA, Bosscha K, van Dam RM et al (2015) A nationwide comparison of laparoscopic and open distal pancreatectomy for benign and malignant disease. J Am Coll Surg 220(3):263-270.e1

    Article  PubMed  Google Scholar 

  9. de Rooij T, van Hilst J, van Santvoort H, Boerma D, van den Boezem P, Daams F et al (2019) Minimally invasive versus open distal pancreatectomy (LEOPARD): a multicenter patient-blinded randomized controlled trial. Ann Surg 269(1):2–9

    Article  PubMed  Google Scholar 

  10. Björnsson B, Larsson AL, Hjalmarsson C, Gasslander T, Sandström P (2020) Comparison of the duration of hospital stay after laparoscopic or open distal pancreatectomy: randomized controlled trial. Br J Surg 107(10):1281–1288

    Article  PubMed  Google Scholar 

  11. de Rooij T, Lu MZ, Steen MW, Gerhards MF, Dijkgraaf MG, Busch OR et al (2016) Minimally invasive versus open pancreatoduodenectomy: systematic review and meta-analysis of comparative cohort and registry studies. Ann Surg 264(2):257–267

    Article  PubMed  Google Scholar 

  12. Nassour I, Wang SC, Christie A, Augustine MM, Porembka MR, Yopp AC et al (2018) Minimally invasive versus open pancreaticoduodenectomy: a propensity-matched study from a national cohort of patients. Ann Surg 268(1):151–157

    Article  PubMed  Google Scholar 

  13. Poves I, Burdío F, Morató O, Iglesias M, Radosevic A, Ilzarbe L et al (2018) Comparison of perioperative outcomes between laparoscopic and open approach for pancreatoduodenectomy: the PADULAP randomized controlled trial. Ann Surg 268(5):731–739

    Article  PubMed  Google Scholar 

  14. Yi X, Chen S, Wang W, Zou L, Diao D, Zheng Y et al (2017) A systematic review and meta-analysis of laparoscopic and open distal pancreatectomy of nonductal adenocarcinomatous pancreatic tumor (NDACPT) in the pancreatic body and tail. Surg Laparosc Endosc Percutan Tech 27(4):206–219

    Article  PubMed  Google Scholar 

  15. Wu J, Tian X, Liu B, Li C, Hao C (2018) Features and treatment of peritoneal metastases from solid pseudopapillary neoplasms of the pancreas. Med Sci Monit 24:1449–1456

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tajima Y, Kohara N, Maeda J, Inoue K, Kitasato A, Natsuda K et al (2012) Peritoneal and nodal recurrence 7 years after the excision of a ruptured solid pseudopapillary neoplasm of the pancreas: report of a case. Surg Today 42(8):776–780

    Article  PubMed  Google Scholar 

  17. Coelho JCU, da Costa MAR, Ramos EJB, Torres AR, Savio MC, Claus CMP (2018) Surgical management of solid pseudopapillary tumor of the pancreas. JSLS 22:4

    Article  Google Scholar 

  18. Hao EIU, Rho SY, Hwang HK, Chung JU, Lee WJ, Yoon DS et al (2019) Surgical approach to solid pseudopapillary neoplasms of the proximal pancreas: minimally invasive vs open. World J Surg Oncol 17(1):160

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kang CM, Choi SH, Hwang HK, Lee WJ, Chi HS (2011) Minimally invasive (laparoscopic and robot-assisted) approach for solid pseudopapillary tumor of the distal pancreas: a single-center experience. J Hepatobiliary Pancreat Sci 18(1):87–93

    Article  PubMed  Google Scholar 

  20. Zhang RC, Yan JF, Xu XW, Chen K, Ajoodhea H, Mou YP (2013) Laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor of the pancreas. World J Gastroenterol 19(37):6272–6277

    Article  PubMed  PubMed Central  Google Scholar 

  21. Namgoong JM, Kim DY, Kim SC, Kim SC, Hwang JH, Song KB (2014) Laparoscopic distal pancreatectomy to treat solid pseudopapillary tumors in children: transition from open to laparoscopic approaches in suitable cases. Pediatr Surg Int 30(3):259–266

    Article  PubMed  Google Scholar 

  22. Stewart CL, Meguid C, Chapman B, Schulick R, Edil BH (2016) Evolving trends towards minimally invasive surgery for solid-pseudopapillary neoplasms. Ann Surg Oncol 23(13):4165–4168

    Article  PubMed  Google Scholar 

  23. Tan HL, Tan EK, Teo JY, Kam JH, Lee SY, Cheow PC et al (2019) Outcome of minimally-invasive versus open pancreatectomies for solid pseudopapillary neoplasms of the pancreas: a 2:1 matched case-control study. Ann Hepatobiliary Pancreat Surg 23(3):252–257

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tan HL, Syn N, Goh BKP (2019) Systematic review and meta-analysis of minimally invasive pancreatectomies for solid pseudopapillary neoplasms of the pancreas. Pancreas 48(10):1334–1342

    Article  PubMed  Google Scholar 

  25. Silano F, de Melo Amaral RB, Santana RC, Neves VC, Ardengh JC, do Amaral PCG (2021) Yield of surgery in solid pseudopapillary neoplasms of the pancreas: a case series and literature review. World J Gastrointest Oncol. 13(6):589–599

    Article  PubMed  PubMed Central  Google Scholar 

  26. Cai Y, Ran X, Xie S, Wang X, Peng B, Mai G et al (2014) Surgical management and long-term follow-up of solid pseudopapillary tumor of pancreas: a large series from a single institution. J Gastrointest Surg mai 18(5):935–940

    Article  Google Scholar 

  27. de Ponthaud C, Grégory J, Pham J, Martin G, Aussilhou B, Ftériche FS et al (2022) Resection of the splenic vessels during laparoscopic central pancreatectomy is safe and does not compromise preservation of the distal pancreas. Surgery 172(4):1210–1219

    Article  PubMed  Google Scholar 

  28. Dokmak S, Ftériche FS, Aussilhou B, Lévy P, Ruszniewski P, Cros J et al (2017) The Largest European Single-Center Experience: 300 laparoscopic pancreatic resections. J Am Coll Surg 225(2):226-234.e2

    Article  PubMed  Google Scholar 

  29. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196

    Article  PubMed  Google Scholar 

  30. Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA (2013) The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg 258(1):1–7

    Article  PubMed  Google Scholar 

  31. Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591

    Article  PubMed  Google Scholar 

  32. Kang CM, Choi SH, Kim SC, Lee WJ, Choi DW, Kim SW et al (2014) Predicting recurrence of pancreatic solid pseudopapillary tumors after surgical resection: a multicenter analysis in Korea. Ann Surg 260(2):348–355

    Article  PubMed  Google Scholar 

  33. Yepuri N, Naous R, Meier AH, Cooney RN, Kittur D, Are C et al (2020) A systematic review and meta-analysis of predictors of recurrence in patients with solid pseudopapillary tumors of the pancreas. HPB (Oxford) 22(1):12–19

    Article  PubMed  Google Scholar 

  34. Marchegiani G, Andrianello S, Massignani M, Malleo G, Maggino L, Paiella S et al (2016) Solid pseudopapillary tumors of the pancreas: specific pathological features predict the likelihood of postoperative recurrence. J Surg Oncol 114(5):597–601

    Article  PubMed  Google Scholar 

  35. Yao J, Song H (2020) A review of clinicopathological characteristics and treatment of solid pseudopapillary tumor of the pancreas with 2450 cases in Chinese population. Biomed Res Int 2020:2829647

    Article  PubMed  PubMed Central  Google Scholar 

  36. Karsenti D, Caillol F, Chaput U, Perrot B, Koch S, Vuitton L et al (2020) Safety of endoscopic ultrasound-guided fine-needle aspiration for pancreatic solid pseudopapillary neoplasm before surgical resection: a European Multicenter Registry-based study on 149 patients. Pancreas 49(1):34–38

    Article  PubMed  Google Scholar 

  37. Wang M, Li D, Chen R, Huang X, Li J, Liu Y et al (2021) Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours: a multicentre, open-label, randomised controlled trial. Lancet Gastroenterol Hepatol 26:1

    Google Scholar 

  38. van Hilst J, de Rooij T, Bosscha K, Brinkman DJ, van Dieren S, Dijkgraaf MG et al (2019) Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial. Lancet Gastroentero Hepatol 4(3):199–207

    Article  Google Scholar 

  39. Carricaburu E, Enezian G, Bonnard A, Berrebi D, Belarbi N, Huot O et al (2003) Laparoscopic distal pancreatectomy for Frantz’s tumor in a child. Surg Endosc 17(12):2028–2031

    Article  CAS  PubMed  Google Scholar 

  40. Alvise C, Giovanni B, Despoina D, Roberto S, Gianluigi M, Micaela P et al (2011) Laparoscopic pancreatectomy for solid pseudo-papillary tumors of the pancreas is a suitable technique; our experience with long-term follow-up and review of the literature. Ann Surg Oncol 18(2):352–357

    Article  Google Scholar 

  41. Senthilnathan P, Dhaker KC, Kaje V, Naidu SB, Sarvani M, Sabnis SC et al (2017) Laparoscopic management of solid pseudo papillary neoplasm of pancreas in tertiary care center from south India. Pancreatology 17(6):927–930

    Article  PubMed  Google Scholar 

  42. Afridi SA, Kazaryan AM, Marangos IP, Røsok BI, Fretland ÅA, Yaqub S et al (2014) Laparoscopic surgery for solid pseudopapillary tumor of the pancreas. JSLS 18(2):236–242

    Article  PubMed  PubMed Central  Google Scholar 

  43. Nakamura Y, Matsushita A, Katsuno A, Yamahatsu K, Sumiyoshi H, Mizuguchi Y et al (2016) Clinical outcomes for 14 consecutive patients with solid pseudopapillary neoplasms who underwent laparoscopic distal pancreatectomy. Asian J Endosc Surg 9(1):32–36

    Article  PubMed  Google Scholar 

  44. Asbun HJ, Moekotte AL, Vissers FL, Kunzler F, Cipriani F, Alseidi A et al (2020) For the International Study Group on Minimally Invasive Pancreas Surgery (I-MIPS). The Miami international evidence-based guidelines on minimally invasive pancreas resection. Ann Surg 271(1):1–14

    Article  PubMed  Google Scholar 

  45. Abu Hilal M, van Ramshorst TME, Boggi U, Dokmak S, Edwin B, Keck T et al (2023) The Brescia internationally validated European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS). Ann Surg 279:45

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. AP-HP, Hôpital Beaujon, Department of HPB Surgery and Liver Transplantation, DMU DIGEST, University Paris Cité, Clichy, France

    Tatiana Codjia, Lancelot Marique, Béatrice Aussilhou, Fadhel Samir Ftériche, Mickael Lesurtel, Alain Sauvanet & Safi Dokmak

  2. AP-HP, Hôpital Beaujon, Department of Gastroenterology and Pancreatic Diseases, DMU DIGEST, University Paris Cité, Clichy, France

    Louis de Mestier, Vinciane Rebours, Philippe Ruszniewski & Philippe Lévy

  3. AP-HP, Hôpital Beaujon, Department of Pathology, University Paris Cité, Clichy, France

    Jérome Cros

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  1. Tatiana Codjia
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  2. Lancelot Marique
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  3. Béatrice Aussilhou
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  9. Philippe Lévy
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  11. Alain Sauvanet
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Correspondence to Safi Dokmak.

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Disclosures

Tatiana Codjia, Lancelot Marique, Béatrice Aussilhou, Fadhel Samir Ftériche, Louis de mestier, Vinciane Rebours, Jérome Cros, Philippe Ruszniewski, Philippe Lévy, Mickael Lesurtel, Alain Sauvanet and Safi Dokmak have no conflicts of interest or financial ties to disclose in relation to the results of the present study.

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Codjia, T., Marique, L., Aussilhou, B. et al. Outcome and survival were similar with laparoscopic and open pancreatectomy in 102 solid pseudopapillary neoplasms. Surg Endosc 38, 2169–2179 (2024). https://doi.org/10.1007/s00464-024-10708-y

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