Enucleation for benign or low-grade malignant lesions of the pancreas: Single-center experience with 65 consecutive patients
Enucleation for benign or low-grade malignant lesions of the pancreas: Single-center experience with 65 consecutive patients
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DOI：
10.1016/j.surg.2014.10.008
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发表时间：
2015-11-01
期刊：
影响因子：
3.8
通讯作者：
Lee, Young-Joo
中科院分区：
文献类型：
--
作者：
Song, Ki Byung;Kim, Song Cheol;Lee, Young-Joo
介绍。胰腺良性和交界性肿瘤的标准切除与术后发病率和长期功能损害的重大风险相关，而去核可降低发病率并保留健康的实质和胰腺功能。本研究的目的是评价胰腺去核术后的临床结果和远期功能及肿瘤结果，并比较腹腔镜和开放式胰腺去核的临床结果。从2005年3月至2013年12月，通过对医疗记录的回顾性分析，发现65例胰腺良性肿瘤去核。大多数患者为女性（73.8%），中位年龄为52.7岁（四分位数间43.1 ~ 60.9岁）。中位肿瘤大小为2.5 cm（四分位数范围1.6-3.8 cm）。胰腺神经内分泌肿瘤是最常见的切除指征（24.36.9%）。1例临床相关胰瘘（International Study Group on pancreatic瘘grade B， C）报道：胰颈肿瘤患者除核后并发症发生率高于其他部位肿瘤患者（3/ 4,75%）。开放式和腹腔镜下摘除组的临床结果无差异。在58.7个月的中位随访中，有1例新发糖尿病，无复发或死亡。摘除胰腺核是一种安全有效的治疗良性和交界性胰腺肿瘤的方法。它保留了胰腺功能，与复发无关。术后并发症的发生率，包括胰瘘，是可以接受的。腹腔镜下摘除术似乎是一种可行和安全的方法，与良好的围手术期结果有关。
Introduction. Standard resection for benign and borderline neoplasms of the pancreas is associated with a substantial risk of postoperative morbidity and long-term functional impairment, whereas enucleation leads to less morbidity and preserves healthy parenchyma as well as pancreatic function. The aim of this study was to evaluate the postoperative clinical outcomes and long-term functional and oncologic results after pancreatic enucleation, and to compare the clinical results of laparoscopic and open enucleation.Methods. From March 2005 to December 2013, 65 cases of enucleation of benign tumors in the pancreas were identified through a retrospective review of medical records.Results. Most of the patients were women (73.8 %), and the median age was 52.7 years (interquartile range 43.1-60.9 years). Median tumor size was 2.5 cm (interquartile range 1.6-3.8 cm). The most common indication for enucleation was pancreatic neuroendocrine tumor (24, 36.9%). A clinically relevant pancreatic fistula (International Study Group on Pancreatic Fistula grade B, C) was reported The patients with tumors of the pancreatic neck had more complications after enucleation than those with tumors at other locations (3/4, 75%). There were no differences of clinical outcomes between open and laparoscopic enucleation groups. At a median follow-up of 58.7 months there was one case of new-onset diabetes, and there were no recurrences or deaths.Conclusion. Enucleation is a safe and effective procedure for the treatment of benign and borderline pancreatic neoplasms. It preserves pancreatic function and is not associated with recurrence. The incidence of postoperative complications, including pancreatic fistula, is acceptable. Laparoscopic enucleation seems to be a feasible and safe approach associated with favorable perioperative outcomes for the selected patients.