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Parenchyma-sparing surgery for pancreatic endocrine tumors

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Abstract

Enucleation (EN) and middle pancreatectomy (MP) have been proposed as a treatment for G1 and G2 pancreatic neuroendocrine tumors (PNET). The aim of this study is to analyze the outcomes of parenchyma-sparing surgery (PSS) for PNET in an Italian high-volume center. All patients with a histological diagnosis of PNET who underwent surgical resection in our center between January 2010 and January 2016 were included in the study. Demographic, perioperative, and discharge data were collected in a prospective database. Follow-up was considered until March 31, 2016. 99 patients were included. PSS was performed in 22 cases (22.2 %), 18 EN (82 %), and 4 MP (18 %). 89.8 % patients were staged with CT scan, 69.6 % with endoscopic ultrasonography, 48.4 % with MRI, and 47.4 % with 68Ga-PET. Pre-operative histological diagnosis was obtained in 68.6 %. Most of PSS tumors were G1 (n = 15; 68 %) and there were no G3. Nodal sampling was performed in every PSS. Only two patients showed nodal metastatic disease. The median post-operative length of stay was 7 days after PSS. Eleven (50 %) of these patients developed a complication; two (18.2 %) were major complications. Pancreatic fistula developed in ten patients (45.5 %); two (20 %) were type B. There were no type C fistula and no re-operations after PSS. Readmission rate was 9 %. All patients submitted to PSS are alive and free of recurrence. PSS is a safe technique for G1 and G2 PNETs, but it has to be conducted in experienced centers and an extensive nodal sampling and a long follow-up are required for the best oncologic outcome.

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Authors and Affiliations

  1. Pancreatic Surgery Unit-Hospital Health Direction, Humanitas Research Hospital, Rozzano, MI, Italy

    Fara Uccelli, F. Gavazzi, G. Capretti, M. Virdis & A. Zerbi

  2. Chancellor of Humanitas University, Chief of Department of Surgery, Humanitas Research Hospital, Rozzano, Italy

    M. Montorsi

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  1. Fara Uccelli
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Correspondence to Fara Uccelli.

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The authors declare that there is no conflict of interests regarding the publication of this paper.

Ethical approval

The present study received our local ethical committee approval and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors. This article is also compliant with ethical standard for research involving human participants.

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All patients gave their informed consent for data collection prior to their inclusion in this study.

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Uccelli, F., Gavazzi, F., Capretti, G. et al. Parenchyma-sparing surgery for pancreatic endocrine tumors. Updates Surg 68, 313–319 (2016). https://doi.org/10.1007/s13304-016-0400-1

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  • DOI: https://doi.org/10.1007/s13304-016-0400-1

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