Laparoscopic central pancreatectomy for solid pseudopapillary tumors of the pancreas: our experience with ten cases
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Laparoscopic central pancreatectomy for solid pseudopapillary tumors of the pancreas: our experience with ten cases Xue-Min Chen*†, Yue Zhang† and Dong-Lin Sun
Abstract Background: Solid pseudopapillary tumors (SPTs) of the pancreas are a rare neoplasm. There are few reports of laparoscopic central pancreatectomies (LCPs) for SPT of the pancreas. The objective of this study was to evaluate the feasibility, safety and long-term outcome of LCP based on a series of SPT patients. Methods: This retrospective study included ten patients who underwent LCP between 2009 and 2013. Clinical characteristics and intra- and postoperative data were retrospectively analyzed. A follow-up of at least 3 months was available for all patients. Results: All procedures were successfully performed laparoscopically, and no patient required intraoperative blood transfusion. The median operative time was 271 min (range 250 to 310 min) and the median loss of blood was 104 ml (range 80 to 150 ml). The mean tumor size was 51 mm (range 38 to 62 mm). All patients underwent complete resection with negative surgical margin. An average of 5.8 lymph nodes were resected without metastases. The median first flatus time was 2 days, and the median starting time for diet was 3 days. The median postoperative hospital stay was 13 days (range 10 to 23 days). Morbidity was 20%. The median follow-up was 22.9 months (range 3 to 48 months), at which point all patients were alive with no recurrence. None of the patients developed exocrine or endocrine insufficiency. No hospital mortalities occurred in our patient group. Conclusions: LCP is a safe and effective technique for resecting SPT of the neck and proximal body of the pancreas while preserving pancreatic endocrine and exocrine function, and the spleen. Keywords: Solid pseudopapillary tumor, Pancreatic tumor, Laparoscopic central pancreatectomy
Background Solid pseudopapillary tumors (SPTs) are a rare clinical entity, representing 1% to 2% of all primary exocrine tumors of the pancreas; more than 80% of patients are female [1]. SPT is of unclear histopathogenesis, and lowgrade malignancy, malignant degeneration and lymph node metastasis rarely occur [2]. Surgical resection of this tumor can result in long-term survival. Laparoscopic resection of the pancreas was initially described in the medical literature in the early 1990s. The first laparoscopic pancreatoduodenectomy was performed in 1994, and the first distal pancreatectomy was performed in * Correspondence: [email protected] † Equal contributors Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
1996 [3,4]. However, patients who require central pancreatectomy are still being treated with the open approach or with laparoscopic distal pancreatectomy. Central pancreatectomy is an alternative technique for benign or low-grade malignant tumors of the neck of the pancreas. This pancreas-sparing technique was developed to avoid exocrine an
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