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Erschienen in: World Journal of Surgery 10/2018

24.04.2018 | Original Scientific Report

Minimally Invasive Versus Open Treatment for Benign Sporadic Insulinoma Comparison of Short-Term and Long-Term Outcomes

verfasst von: Giulio Belfiori, Dominik Wiese, Stefano Partelli, Sabine Wächter, Elisabeth Maurer, Stefano Crippa, Massimo Falconi, Detlef K. Bartsch

Erschienen in: World Journal of Surgery | Ausgabe 10/2018

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Abstract

Background

Benign insulinoma is the most common functioning neuroendocrine tumor of the pancreas, and its incidence is estimated at 0.4%. The treatment of choice is organ-preserving resection. The aim of this study was to compare short-term and long-term outcomes of minimally invasive laparoscopic or robotic enucleation (MIC-EN) and open enucleation (O-EN) for sporadic benign insulinoma.

Methods

A retrospective bi-institutional analysis of 71 patients who underwent an enucleation for sporadic benign insulinoma between 2003 and 2016 was performed. Patients were analyzed according to intention-to-treat principle.

Results

Fifteen (21%) patients underwent MIC-EN (three robotic and 12 laparoscopic) and 56 (79%) patients O-EN. In all MIC-EN patients, the insulinoma was localized by preoperative imaging compared to only 62.5% (35 of 56) patients in the O-EN group (p = 0.005). Three of the MIC-EN patients (20%) with insulinomas in the pancreatic head had to undergo a conversion. Excluding conversions, MIC-EN procedures were shorter (145 vs 180, p = 0.036) compared to O-EN surgery. Late complications and pathological data did not differ between groups, excluding margin status R1 MIC-EN (26.7%) compared to O-EN (10.7%, p = 0.115). After a median follow-up of 75 (range 1–151) months, all patients were alive, but four (5.6%) patients (one after MIC-EN and three after O-EN) developed a functional recurrence. No patient with a R1 resection had a disease recurrence.

Conclusions

MIC-EN for benign sporadic insulinoma is a safe procedure with at least similar short-term and long-term postoperative outcomes as the open technique. Thus, preoperatively localized benign insulinoma should be approached laparoscopically, if technically feasible.
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Metadaten
Titel
Minimally Invasive Versus Open Treatment for Benign Sporadic Insulinoma Comparison of Short-Term and Long-Term Outcomes
verfasst von
Giulio Belfiori
Dominik Wiese
Stefano Partelli
Sabine Wächter
Elisabeth Maurer
Stefano Crippa
Massimo Falconi
Detlef K. Bartsch
Publikationsdatum
24.04.2018
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 10/2018
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4628-4

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