Clinical efficacy of the laparoscopic resection for pancreatic neuroendocrine neoplasms

Objective To investigate the clinical efficacy of laparoscopic resection for pancreatic neuroendocrine neoplasms (pNENs).Methods The clinical data of 31 patients who received laparoscopic resection for pNENs at the Sir Run Run Show Hospital of Zhejiang University from March 2005 to June 2014 were retrospectively analyzed.The surgical procedure was selected according to the location and size of the pNENs.Patients were followed up via phone call or out-patient examination till August 2014.Results Laparoscopic resection was successfully carried out on all the 31 patients,including laparoscopic enucleation in 4 patients,laparoscopic pancreatoduodenectomy in 2 patients,laparoscopic central pancreatectomy in 2 patients,laparoscopic spleenpreserving distal pancreatectomy in 6 patients and laparoscopic distal pancreatosplenectomy in 17 patients.The operation time,volume of intraoperative blood loss and blood transfusion rate were (205 ± 74)minutes,125 mL (10-1 000 mL) and 9.7％ (3/31),respectively.The time for out-off-bed activity,time to anal exsufflation,time for fluid diet intake and duration of postoperative hospital stay were 2 days (range,1-3 days),3 days (range,1-4 days),3 days (range,1-7 days) and 10 days (range,5-63 days).The incidence of postoperative complications was 35.5％ (11/31),and the complications were cured after symptomatic treatment.No patient died perioperatively.Thirty-one patients were followed up with the follow-up rate of 100.0％.The median time for followup was 21 months (range,5-111 months).One patient had symptom of pancreatic exocrine insufficiency after the operation; 3 patients had diabetes at postoperative month 1 ; 1 patient died of tumor metastases at postoperative year 1 ; 1 patient had Whipple's triad at postoperative year 3,and was confirmed with tumors in the head and tail of the pancreas by magnetic resonance imaging.No tumor recurrence or metastasis was detected in the other patients.Conclusions Laparoscopic resection is safe and feasible for the treatment of pNENs.The surgical procedure is selected based on the location and size of the pNENs.Laparoscopic resection of pNENs has the advantages of small trauma,quick recovery of the patients and favorable short-and long-term efficacy. Key words: Neuroendocrine neoplasms ;  Pancreas ;  Laparoscopy