Skip to main content

Advertisement

SpringerLink
Log in

The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours

  • Neuroendocrine Cancers (M Cives, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

An Author Correction to this article was published on 18 March 2021

This article has been updated

Opinion statement

Pancreatic neuroendocrine tumours (PNETs) are a rare and heterogeneous group of tumours with various clinical manifestations and biological behaviours. They represent approximately 2–4% of all pancreatic tumours, with an incidence of 2–3 cases per million people. PNETs are classified clinically as non-functional or functional, and pancreatic resection is recommended for lesions greater than 2 cm. The surgical approach can involve “typical” and “atypical” resections depending on the number, size and location of the tumour. Typical resections include pancreaticoduodenectomy, distal pancreatectomy enucleation and, rarely, total pancreatectomy. Atypical resections comprise central pancreatectomies or enucleations. Minimally invasive pancreatic resection has been proven to be technically feasible and safe in high-volume and specialized centres with highly skilled laparoscopic surgeons, with consolidated benefits for patients in the postoperative course. However, open and minimally invasive pancreatic surgery remains to have a high rate of complications; there is no specific technical contraindication to minimally invasive pancreatic surgery, but an appropriate patient selection is crucial to obtain satisfactory clinical and oncological outcomes.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Thomaschewski M, Neeff H, Keck T, et al. Is there any role for minimally invasive surgery in NET? Rev Endocr Metab Disord. 2017 Dec;18(4):443–57. https://doi.org/10.1007/s11154-017-9436-x.

    Article  CAS  PubMed  Google Scholar 

  2. Brooks JC, Shavelle RM, Vavra-musser KN. Life expectancy in pancreatic neuroendocrine cancer. Clin Res Hepatol Gastroenterol. 2018;43:88–97. https://doi.org/10.1016/j.clinre.2018.08.005.

    Article  PubMed  Google Scholar 

  3. Paniccia A, Edil BH, Schulick RD. Pancreatic Neuroendocrine Tumors : an Update. 2017;77:395–402. https://doi.org/10.1007/s12262-015-1360-2.

  4. Mansour JC, Chavin K, Morris-stiff G, et al. Management of asymptomatic, well differentiated PNETs : results of the Delphi consensus process of the Americas Hepato- Pancreato Biliary Association. Int Hepato-Pancreato-Biliary Assoc. HPB (Oxford). 2019 May;21(5):515–23. https://doi.org/10.1016/j.hpb.2018.09.020.

    Article  Google Scholar 

  5. Memeo R, Roselli S, Lupo L, Cherkaoui Z, Pessaux P. Laparoscopic management of neuroendocrine tumors : state-of- the-art. 2017. https://doi.org/10.21037/tgh.2017.11.19.

  6. Tamburrino D, Partelli S, Renzi C, et al. Systematic review and meta-analysis on laparoscopic pancreatic resections for neuroendocrine neoplasms ( PNENs). Expert Rev Gastroenterol. 2017. https://doi.org/10.1080/17474124.2017.1253473 This review and meta-analysis shows the safety of laparoscopic approach for the treatment of PNETs . The outcome after pancreatic resection performed with laparoscopic approach is similar compared with the traditional technique.

  7. Zhang J, Jin J, Chen S, et al. Minimally invasive distal pancreatectomy for PNETs:laparoscopic or robotic approach? Oncotarget. 2017 May 16;8(20):33872–83. https://doi.org/10.18632/oncotarget.17513.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Szeliga J, Jackowski M. Pancreatic Neuroendocrine Neoplasms : A Role of Laparoscopy in Surgical Treatment : Review. 2018;00:1–6.

  9. Gharios J, Hain E, Dohan A, et al. Pre- and intraoperative diagnostic requirements , bene fi ts and risks of minimally invasive and robotic surgery for neuroendocrine tumors of the pancreas Pr Fr e. Best Pract Res Clin Endocrinol Metab. 2019. https://doi.org/10.1016/j.beem.2019.101294.

  10. Shirota T, Nagakawa Y, Sahara Y, et al. Surgical resection of neuroendocrine tumors of the pancreas (pNETs) by minimally invasive surgery: the laparoscopic approach. Gland Surg. 2018. https://doi.org/10.21037/gs.2017.11.06.

  11. Zozaya G, Herna L, Rotellar F. Short- and long-term outcomes of laparoscopic organ-sparing resection in pancreatic neuroendocrine tumors : a single-center experience. 2017. https://doi.org/10.1007/s00464-016-5411-y.

  12. Zhang XF, Fields R, Cho C, Aguiar AGL, Weber S, Krasnick BA, et al. Minimally invasive versus open distal pancreatectomy for pancreatic neuroendocrine tumors : an analysis from the U. S . neuroendocrine tumor study group. 2019. https://doi.org/10.1002/jso.25481.

  13. Szeliga J, Jackowski M. Pancreatic Neuroendocrine Neoplasms: A Role of Laparoscopy in Surgical Treatment: Review. Surg Laparosc Endosc Percutan Tech. 2018;28(3):147–52.

    Article  Google Scholar 

  14. Molina DC, Lambreton F, Arrangoiz Majul R. Trends in Robotic Pancreaticoduodenectomy and Distal Pancreatectomy. J Laparoendosc Adv Surg Tech A. 2019. https://doi.org/10.1089/lap.2018.0421.

  15. Paiella S, De Pastena M, Korrel M, et al. Long term outcome after minimally invasive and open Warshaw and Kimura techniques for spleen-preserving distal pancreatectomy: International multicenter retrospective study. Eur J Surg Oncol. 2019;45(9):1668–73. https://doi.org/10.1016/j.ejso.2019.04.004 Epub 2019 PMID: 31005470.

    Article  PubMed  Google Scholar 

  16. Milito P, Aiolfi A, Asti E, Rausa E, Bonitta G, Bonavina L. Impact of spleen preserving laparoscopic distal Pancreatectomy on postoperative infectious complications: systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A. 2019;29(2):167–77. https://doi.org/10.1089/lap.2018.0738 Epub 2018PMID: 30592691.

    Article  PubMed  Google Scholar 

  17. Asbun HJ, Van HJ, Tsamalaidze L, Kawaguchi Y, Sanford D, Pereira L, et al. Technique and audited outcomes of laparoscopic distal pancreatectomy combining the clockwise approach , progressive stepwise compression technique , and staple line reinforcement. Surg Endosc. 2019. https://doi.org/10.1007/s00464-019-06757-3 This article describes an important and useful technical note.

  18. Niess H, Werne J, Liver L. Pancreas, and biliary surgery: textbook and illustrated video atlas, indications and contraindications for laparoscopic pancreas. surgery. 2017:337–48.

  19. Pedrazzoli S. Pancreatoduodenectomy (PD) and postoperative pancreatic fistula (POPF) A systematic review and analysis of the POPF-related mortality rate in 60,739 patients retrieved from the English literature published between 1990 and 2015. Medicine. 2017. https://doi.org/10.1097/MD.0000000000006858.

  20. Izumo W. Evaluation of preoperative risk factors for postpancreatectomy hemorrhage. Langenbeck's Arch Surg. 2019;404:967–74. https://doi.org/10.1007/s00423-019-01830-w.

    Article  Google Scholar 

  21. Duarte Garcés A, Andrianello S, Marchegiani G. Reappraisal of post-pancreatectomy hemorrhage (PPH) classifications: do we need to redefine grades A and B? HPB. 2017. https://doi.org/10.1016/j.hpb.2018.01.013.

  22. Zhang C, Li A, Luo T, Li J, Liu D, et al. Strategy and management of severe hemorrhage complicating pancreatitis and post-pancreatectomy. Intervent Radiol. 2019:81–9. https://doi.org/10.5152/dir.2018.18283.

  23. Xourafas D, Cloyd JM, Clancy TE, et al. Identifying hospital cost savings opportunities by optimizing surgical approach for distal pancreatectomy. J Gastrointest Surg. 2019 Jun;23(6):1172–9. https://doi.org/10.1007/s11605-018-4002-8.

    Article  PubMed  Google Scholar 

  24. Joechle K, Conrad C. Cost-effectiveness of minimally invasive pancreatic resection. 2018:291–8. https://doi.org/10.1002/jhbp.558.

  25. Asbun HJ, Moekotte AL, Vissers FL, International Study Group on Minimally Invasive Pancreas Surgery (I-MIPS). The Miami International. Evidence-based Guidelines on Minimally Invasive Pancreas Resection. Ann Surg. 2020. https://doi.org/10.1097/SLA.0000000000003590 The first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019).

  26. Petzel MQB, Hoffman L. Nutrition implications for long-term survivors of pancreatic cancer surgery. Nutr Clin Pract. 2017. https://doi.org/10.1177/5090884533617722929.

  27. Rodriguez M, Memeo R, Leon P, et al. Which method of distal pancreatectomy is cost-effective among open , laparoscopic , or robotic surgery ? 2018;7:345–52. https://doi.org/10.21037/hbsn.2018.09.03.

  28. Fisher AV, Fernandes-taylor S, Schumacher JR, Havlena JA, Wang X, Lawson EH, et al. Analysis of 90-day cost for open versus minimally invasive distal pancreatectomy. Int Hepato-Pancreato-Biliary Assoc. 2018;21:1–7. https://doi.org/10.1016/j.hpb.2018.07.003.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hepato-Pancreato-Biliary Surgery Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy

    Valentina Ferraro MD, Michele Tedeschi MD, PhD & Riccardo Memeo MD, PhD

  2. Medical Oncology Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy

    Letizia Laera MD & Giammarco Surico MD

  3. Department of Health Sciences, General Surgery, Magna Græcia University, Medicine School of Germaneto, Catanzaro, Italy

    Michele Ammendola MD, PhD

  4. Department of Reconstructive Surgery, “Pugliese Ciaccio” Hospital, Catanzaro, Italy

    Umberto Riccelli MD

  5. Medical Oncology Unit, IRCCS Cancer Institute “Giovanni Paolo II”, Bari, Italy

    Nicola Silvestris MD, PhD

  6. Radiotherapy Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy

    Alba Fiorentino MD, PhD

  7. Interventional Radiology Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy

    Riccardo Inchingolo MD

  8. Gastroenterology and Endoscopy Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy

    Francesco Decembrino MD

  9. Minimally invasive and Robotic Gastrointestinal Surgery, Acquaviva delle Fonti, Bari, Italy

    Nicola de Angelis MD, PhD

Authors
  1. Valentina Ferraro MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michele Tedeschi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Letizia Laera MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michele Ammendola MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Umberto Riccelli MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicola Silvestris MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alba Fiorentino MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Giammarco Surico MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Riccardo Inchingolo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Francesco Decembrino MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nicola de Angelis MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Riccardo Memeo MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Valentina Ferraro MD.

Ethics declarations

Conflict of Interest

Valentina Ferraro declares that she has no conflict of interest.

Michele Tedeschi declares that she has no conflict of interest.

Letizia Laera declares that he has no conflict of interest.

Michele Ammendola declares that she has no conflict of interest.

Umberto Riccelli declares that he has no conflict of interest.

Nicola Silvestris declares that she has no conflict of interest.

Alba Fiorentino declares that she has no conflict of interest.

Giammarco Surico declares that he has no conflict of interest.

Riccardo Inchingololo declares that he has no conflict of interest.

Francesco Decembrino declares that he has no conflict of interest.

Nicola De’Angelis declares that she has no conflict of interest.

Riccardo Memeo declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original online version of this article was revised: The family name of the ninth author, Riccardo Inchingolo, was misspelled as Inchingololo.

This article is part of the Topical Collection on Neuroendocrine Cancers

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ferraro, V., Tedeschi, M., Laera, L. et al. The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours. Curr. Treat. Options in Oncol. 22, 27 (2021). https://doi.org/10.1007/s11864-021-00824-5

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11864-021-00824-5

Keywords

Search

Navigation