Surgical Endoscopy

, Volume 31, Issue 5, pp 2310–2316 | Cite as

Role of laparoscopic enucleation in the treatment of pancreatic lesions: case series and case-matched analysis

  • Mushegh A. SahakyanEmail author
  • Bård Ingvald Røsok
  • Airazat M. Kazaryan
  • Leonid Barkhatov
  • Sven-Petter Haugvik
  • Åsmund Avdem Fretland
  • Dejan Ignjatovic
  • Knut Jørgen Labori
  • Bjørn Edwin



Previous studies report successful application of laparoscopic pancreatic enucleation (LPE). However, the evidence is limited to small series. This study aimed to evaluate the indications, technique and outcome of LPE at a tertiary care institution.


Between February 1998 and April 2016, 45 consecutive LPEs were performed at Oslo University Hospital—Rikshospitalet. Twenty-four (53.3 %) patients subjected to right-sided LPE (RLPE) were compared with 21 (46.7 %) patients who had undergone left-sided LPE (LLPE). A case-matched analysis (1:2) was performed to compare the outcomes following LLPE and laparoscopic distal pancreatectomy (LDP).


Patient demographics, BMI, ASA score and pathological characteristics were similar between the RLPE and LLPE groups. Operative time was slightly longer for RLPE [123 (53–320) vs 102 (50–373) min, P = 0.09]. The rates of severe morbidity (≥Accordion grade III) and clinically relevant pancreatic fistula (grades B/C) were comparable, although with a trend for higher rate of complications following LLPE (16.7 vs 33.3 %; P = 0.19 and 20.8 vs 33.3 %, P = 0.34, respectively). The hospital stay was similar between RLPE and LLPE [5 (2–80) vs 7 (2–52), P = 0.49]. A case-matched analysis demonstrated shorter operating time [145 (90–350) vs 103 (50–233) min, P = 0.02], but higher readmission rate following LLPE (25 vs 3.1 %, P = 0.037).


LLPE seems to be associated with a higher risk of postoperative morbidity and readmission rates than LDP. RLPE is a feasible, safe approach and a reasonable alternative to pancreatoduodenectomy in selected patients with pancreatic lesions.


Laparoscopy Enucleation Pancreatectomy Morbidity Pancreatic fistula 


Compliance with ethical standards


Mushegh A. Sahakyan, Bård Ingvald Røsok, Airazat M. Kazaryan, Leonid Barkhatov, Sven-Petter Haugvik, Åsmund Avdem Fretland, Dejan Ignjatovic, Knut-Jørgen Labori and Bjørn Edwin have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Mushegh A. Sahakyan
    • 1
    • 2
    • 3
    Email author
  • Bård Ingvald Røsok
    • 4
  • Airazat M. Kazaryan
    • 1
    • 5
  • Leonid Barkhatov
    • 1
    • 2
  • Sven-Petter Haugvik
    • 2
    • 6
  • Åsmund Avdem Fretland
    • 1
    • 2
    • 5
  • Dejan Ignjatovic
    • 5
  • Knut Jørgen Labori
    • 4
  • Bjørn Edwin
    • 1
    • 2
    • 4
  1. 1.The Intervention CentreOslo University Hospital - RikshospitaletOsloNorway
  2. 2.Institute of Clinical Medicine, Medical FacultyUniversity of OsloOsloNorway
  3. 3.Department of Surgery No 1Yerevan State Medical University After M. HeratsiYerevanArmenia
  4. 4.Department of HPB SugeryOslo University Hospital - RikshospitaletOsloNorway
  5. 5.Department of Digestive SurgeryAkershus University Hospital, University of OsloLørenskogNorway
  6. 6.Department of SurgeryDrammen Hospital, Vestre Viken Hospital TrustDrammenNorway

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