Skip to main content

Advertisement

SpringerLink
Log in

Neuroendocrine pancreatic tumors: the laparoscopic approach

Die laparoskopische Chirurgie neuroendokriner Pankreastumore

  • Main Topic
  • Published:
European Surgery Aims and scope Submit manuscript

Zusammenfassung

GRUNDLAGEN: Laparoskopische Eingriffe am Pankreas bei Patienten mit neuroendokrinen Tumoren befinden sich in Bezug auf ihre Indikationen und ihre Technik noch in der Evaluationsphase. Das Ziel dieser Arbeit ist einerseits die klinischen und die histologischen Aspekte unterschiedlicher neuroendokriner Tumore des Pankreas zu diskutieren und andererseits ihre chirurgischen Therapiemöglichkeiten in Bezug auf die laparoskopische Chirurgie zu evaluieren. METHODIK: Wir stellen einen Überblick über die unterschiedlichen Formen der minimal invasiven Techniken für die Therapie neuroendokriner Pankreastumore dar. Welcher Patient von welchem laparoskopischen Eingriff profitieren wird, kann nur durch ausreichende Information über die Erkrankung erarbeitet werden. ERGEBNISSE: In Abhängigkeit von der Lokalisation, Größe und der Nähe des Tumors zum Pankreasgang hängt die Notwendigkeit der laparoskopischen Enukleation oder einer distalen Pankreasresektion ab. Die Milzerhaltung während einer laparoskopischen distalen Pankreasresektion ist möglich. SCHLUSSFOLGERUNGEN: Die laparoskopische Enukleation oder laparoskopische Pankreasresektion bringen bei Patienten mit einem neuroendokrinen Pankreastumor einen klaren Vorteil in Bezug auf Kürzung des Spitalsaufenthaltes, rasche Erholung, früherem Erlangen der körperlichen Aktivitäten und einem exzellenten kosmetischen Ergebnis. Die genaue Auswahl der Patienten ist eine unerlässliche Bedingung für ein erfolgreiches Ergebnis.

Summary

BACKGROUND: Laparoscopic pancreatic procedures in patients with neuroendocrine pancreatic tumors are still at an evaluation stage with regard to their indications and techniques. The aim of this paper is to discuss the clinical and pathological features of a variety of neuroendocrine pancreatic tumors and the surgical approach by means of minimally access surgery. METHODS: We provide an overview of the different minimally access techniques for the treatment of neuroendocrine pancreatic tumors. This knowledge will provide the information needed to ascertain the suitability of the laparoscopic approach for any particular patient. RESULTS: Laparoscopic treatment consists of enucleation or distal pancreatectomy; the choice is based on the size, location and proximity of the lesion to the pancreatic duct. Splenic preservation is feasible when performing laparoscopic distal pancreatectomy. CONCLUSIONS: Laparoscopic pancreatic enucleation or laparoscopic pancreatic resection offers a clear benefit for patients with neuroendocrine pancreatic tumors in terms of reduction of hospital stay, a rapid recovery to initiate previous activities and excellent cosmesis. Careful selection of patients is essential to successful outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • McStay M, Caplin ME (2004) GI hormone producing tumors: syndromes and treatment options. In: Johnson CD, Imrie CW (eds) Pancreatic disease. Basic science and clinical management. Springer, London Berlin Heidelberg, pp 31–53

    Google Scholar 

  • Fernandez-Cruz L, Herrera M, Saenz A, Pantoja JP, Astudillo E, Sierra M (2001) Laparoscopic pancreatic surgery in patients with neuroendocrine tumors: indications and limits. In: Fardon JR (ed) Best Practice Research Clinical Endocrinology and Metabolism 15: 161–176

  • Fernandez-Cruz L, Saenz A, Astudillo E (2002) Outcome of laparoscopic pancreatic surgery: endocrine and nonendocrine tumors. World J Surg 26: 1057–1065

    Article  PubMed  CAS  Google Scholar 

  • Fernandez-Cruz L, Martinez I, Cesar-Borges G, Astudillo E, Orduña D, Halperin I, Sesmilo G, Puig M (2005) Laparoscopic surgery in patients with sporadic and multiple insulinomas associated with multiple endocrine neoplasia type 1. J Gastrointest Surg 9: 381–388

    Article  PubMed  Google Scholar 

  • Pietrabissa A, Shimi SM, Vander G, Cushieri A (1993) Localization of insulinoma by infragastric inspection of the pancreas and contact ultrasonography. Surg Oncol 2: 280–285

    Article  Google Scholar 

  • Gagner M, Pomp A, Herrera MF (1996) Experience with laparoscopic resections of islet cell tumors. Surgery 120: 1051–1054

    Article  PubMed  CAS  Google Scholar 

  • Sussman LA, Christie R, Whittle DE (1996) Laparoscopic excision of distal pancreas including insulinoma. Aust N Z J Surg 66: 414–416

    PubMed  CAS  Google Scholar 

  • Chapuis Y, Bigourdan JM, Massault PP, Pitre J, Palazzo L (1998) Exerese video-laparoscopique des insulinomas: etude de cinq observations. Chirurgie 123: 461–467

    Article  PubMed  CAS  Google Scholar 

  • Tihanyi TF, Morvat K, Nehez L (1997) Laparoscopic distal resection of the pancreas with preservation of the spleen. Acta Chir Hung 36: 359–361

    PubMed  CAS  Google Scholar 

  • Burpee ST, Jossart G, Gagner M (1999) The laparoscopic approach to gastroenteropancreatic tumors. Acta Chir Austriaca 31: 207–213

    Google Scholar 

  • Berends FJ, Cuesta MA, Kazemier G (2000) Laparoscopic detection and resection of insulinomas. Surgery 128: 386–390

    Article  PubMed  CAS  Google Scholar 

  • Gramatica L, Herrera MF, Mercado-Luna A (2002) Videolaparoscopic resection of insulinoma: experience in two institutions. World J Surg 26: 1297–1300

    Article  PubMed  Google Scholar 

  • Iihara M, Obara T (2002) Minimally invasive endocrine surgery: laparoscopic resection of insulinomas. Biomed Pharmacother 56: 227–230

    Article  Google Scholar 

  • Lo CY, Chan WF, Lo CM, Fan ST, Tam PKH (2004) Surgical treatment of pancreatic insulinomas in the era of laparoscopy. Surg Endosc 18: 297–302

    Article  PubMed  Google Scholar 

  • van Nieuwenhove Y, Vandaele S, Op de Beeck B, Delvaux G (2003) Neuroendocrine tumors of the pancreas. Surg Endosc 17: 1658–1662

    Article  PubMed  CAS  Google Scholar 

  • Smith SL, Branton SA, Avino AJ (1998) Vasoactive intestinal polypeptide secreting islet cell tumors: a 15 years experience and review of the literature. Surgery 124: 1050

    Article  PubMed  CAS  Google Scholar 

  • Demeure M, Klonoff D, Karam J, Duh Q, Clark O (1991) Insulinomas associated with multiple endocrine neoplasia type 1: the need for a different surgical approach. Surgery 110: 998–1005

    PubMed  CAS  Google Scholar 

  • Cushieri SA, Jakimowics JJ (1998) Laparoscopic pancreatic resections. Semin Laparosc Surg S: 168–179

    Google Scholar 

  • Cushieri SA, Jakimowics JJ (1998) Laparoscopic pancreatic resections. Semin Laparosc Surg S: 168–179

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut Clinic de Malalties Digestives, Departament of Surgery, Hospital Clínic i Provincial de Barcelona, University of Barcelona, Spain

    L. Fernández-Cruz, C. Olvera, R. R. Lozano-Salazar, J. Bollo, J. Ardid & M. A. López-Boado

Authors
  1. L. Fernández-Cruz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Olvera
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. R. Lozano-Salazar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Bollo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Ardid
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. A. López-Boado
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Fernández-Cruz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fernández-Cruz, L., Olvera, C., Lozano-Salazar, R. et al. Neuroendocrine pancreatic tumors: the laparoscopic approach. Eur Surg 38, 384–389 (2006). https://doi.org/10.1007/s10353-006-0290-4

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-006-0290-4

Schlüsselwörter

Keywords

Search

Navigation