Long-Term Outcome of Laparoscopic Surgery for Pancreatic Neuroendocrine Tumors
Corresponding Author
Sven-Petter Haugvik
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
[email protected]Search for more papers by this authorIrina Pavlik Marangos
Interventional Centre, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorBård Ingvald Røsok
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorEwa Pomianowska
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Search for more papers by this authorIvar Prydz Gladhaug
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Search for more papers by this authorØystein Mathisen
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorBjørn Edwin
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Interventional Centre, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorCorresponding Author
Sven-Petter Haugvik
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
[email protected]Search for more papers by this authorIrina Pavlik Marangos
Interventional Centre, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorBård Ingvald Røsok
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorEwa Pomianowska
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Search for more papers by this authorIvar Prydz Gladhaug
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Search for more papers by this authorØystein Mathisen
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorBjørn Edwin
Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
Interventional Centre, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
Search for more papers by this authorAbstract
Background
As most pancreatic neuroendocrine tumors (PNET) are relatively small and solitary, they may be considered well suited for removal by a minimally invasive approach. There are few large series that describe laparoscopic surgery for PNET. The primary aim of this study was to describe the feasibility, outcome, and histopathology associated with laparoscopic pancreatic surgery (LS) of PNET in a large series.
Methods
All patients with PNET who underwent LS at a single hospital from March 1997 to April 2011 were included retrospectively in the study.
Results
A total of 72 patients with PNET underwent 75 laparoscopic procedures, out of which 65 were laparoscopic resections or enucleations. The median operative time of all patients who underwent resections or enucleations was 175 (60–520) min, the median blood loss was 300 (5–2,700) ml, and the median length of hospital stay was 7 (2–27) days. The overall morbidity rate was 42 %, with a surgical morbidity rate of 21 % and postoperative pancreatic fistula (POPF) formation in 21 %. Laparoscopic enucleations were associated with a higher rate of POPF than were laparoscopic resections. Five-year disease-specific survival rate was 90 %. The T stage, R stage, and a Ki-67 cutoff value of 5 % significantly predicted 5-year survival.
Conclusion
LS of PNET is feasible with acceptable morbidity and a good overall disease-specific long-term prognosis.
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