Feasibility and outcomes of laparoscopic enucleation for pancreatic neoplasms

Purpose: With the advancement of laparoscopic techniques and instruments, laparoscopic approach for pancreatic lesions has become an increasingly used procedure. But, there are few and limited studies about laparoscopic enuleation (LE) for pancreatic lesions. Therefore, the purpose of this study was to present our experience and to evaluate the clinical outcome of LE for pancreatic benign or borderline malignant tumors. Methods: Between May 2005 and December 2011, 11 patients who underwent LE were analyzed. Candidates for LE met the following criteria: benign or borderline malignant pancreatic tumor, no involvement of main pancreatic duct, and outwardly growing tumor with small tumor bed. Results: All 11 patients (10 women and 1 man with a mean age of 43.1 +/- 11.9 years) who underwent LE were completed laparoscopically without conversion. The mean diameter of tumor was 4.0 +/- 3.3 cm and all cases had benign tumors at the final pathologic diagnosis. One patient (9%) developed pancreatic fistula and mean postoperative hospital stay was 5.5 +/- 1.7 days. During follow-up period (mean, 44.3 +/- 23.9 months), all patients were alive with no recurrence or new onset of diabetes. Conclusion: LE is a safe and effective procedure, and should be considered as a treatment option for pancreatic lesions that do not involve the main pancratic duct and have an outgrowing aspect with small tumor bed.