Abstract
ABSTRACTBackground: Solid pseudopapillary pancreatic neoplasia is usually a large well-circumscribed pancreatic mass, with cystic and solid areas more frequently found in young women. It is a benign pancreatic neoplasia in most cases, therefore minimally invasive surgery could be an interesting approach. Aim: Evaluate the results of minimally invasive surgery for this neoplasia. Methods: Patients with this tumor who underwent minimally invasive pancreatectomies between 2009 and 2015 in a single institution, were analyzed regarding demographic, clinical-pathological futures, post-operative morbidity and disease-free survival. Results: All were women, and their median age was 39 (18-54) years. Two patients with tumor in the head of the pancreas underwent laparoscopic pancreaticoduodenectomy, and another one underwent laparoscopic enucleation. Two patients with tumor in the neck underwent central pancreatectomy. Distal pancreatectomies were performed in the other five, one with splenic preservation. None required blood transfusion or conversion to open surgery. Two (20%) developed clinical relevant pancreatic fistulas, requiring readmission. Median length of postoperative hospital stay was five days (2-8). All resection margins were negative. Patients were followed for a median of 38 months (14-71), and there was no recurrence. Conclusions: Minimally invasive surgery for solid pseudopapillary pancreatic neoplasia is feasible for tumors in different locations in the pancreas. It was associated with acceptable morbidity and respected the oncologic principles for treatment.
Highlights
Solid pseudopapillary neoplasm (SPN) is a rare pancreatic neoplasia with low malignancy potential that occurs mostly in women (87.8%), between 2040years with a mean age of 28 years[13,17,22,30]
Most SPN are discovered incidentally after cross section images exams such as computed tomography (CT) or magnetic resonance (MRI), which usually are sufficient for the diagnosis
The aim of the present study was to analyze the results of a series of patients with SPN operated by minimally invasive approach in a single institution
Summary
Solid pseudopapillary neoplasm (SPN) is a rare pancreatic neoplasia with low malignancy potential that occurs mostly in women (87.8%), between 2040years with a mean age of 28 years[13,17,22,30] Asymptomatic, it can cause vague abdominal pain, abdominal mass, nausea, vomiting or weight loss[10,13]. As most patients are young and shall be cured after resection, concerns about endocrine and exocrine insufficiency are important, because they can impair quality of life[21,24]. Another issue that may have an impact in long-term results is the large incisions required in open approach
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