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Evolving Trends Towards Minimally Invasive Surgery for Solid-Pseudopapillary Neoplasms

Abstract

Background

Solid-pseudopapillary neoplasms are rare pancreatic neoplasms with low malignant potential that predominantly arise in young women. We sought to characterize this population and the evolving trend at our institution towards laparoscopic management.

Methods

We identified all patients at our institution that were surgically treated for solid-pseudopapillary neoplasm from 2008-2015. Demographic and clinical information were queried from the medical record, and descriptive statistics were performed. Student’s t test and chi-square analysis were used for comparison where appropriate.

Results

We identified 11 women and 1 man (average age 26 years; range 14–48 years) who were surgically treated for solid-pseudopapillary neoplasms; 5 with distal pancreatectomy (4 open, 1 laparoscopic), 6 with pancreaticoduodenectomy (3 open, 3 laparoscopic), and 1 open enucleation. From 2008 to 2013, seven of eight (87 %) procedures were performed open. Since 2014, three of four (75 %) procedures have successfully been completed laparoscopically (see video clips). Length of stay was similar for patients who had open versus laparoscopic procedures (8 vs. 9 days, p = 0.61). Two-thirds of patients (5/8) who had open procedures experienced postoperative complications compared with half (2/4) of patients who had laparoscopic procedures (p = 0.28). There have been no recurrences.

Conclusions

Minimally invasive surgical management of solid-pseudopapillary neoplasms is becoming more popular, can be performed safely, and appears to have comparable outcomes to an open approach. Quality of life is an important metric for this relatively young population and may be improved with a laparoscopic approach, which warrants further investigation.

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Correspondence to Camille L. Stewart MD.

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Stewart, C.L., Meguid, C., Chapman, B. et al. Evolving Trends Towards Minimally Invasive Surgery for Solid-Pseudopapillary Neoplasms. Ann Surg Oncol 23, 4165–4168 (2016) doi:10.1245/s10434-016-5491-x

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Keywords

  • Video Clip
  • Pancreatic Fistula
  • Distal Pancreatectomy
  • Gastroduodenal Artery
  • Proper Hepatic Artery