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Laparoscopic vs open resection of pancreatic endocrine neoplasms: single institution’s experience over 14 years

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Abstract

Background

Laparoscopic resection of benign pancreatic endocrine neoplasms (PENs) has become the standard of care for tumors in the pancreatic tail. Over a 14-year period, we have resected both benign and malignant tumors of the entire pancreas laparoscopically and compared our survival and complication rates with open controls.

Materials and methods

We collected our data retrospectively and reviewed our outcomes with an actuarial 5-year survival according to Kaplan–Meier. Patients who underwent minimally invasive techniques were compared to patients who were approached with open techniques.

Results

From April 1992 to September 2006, we operated on 31 patients for PENs: 13 (42%) were operated on using open techniques and 18 (58%) laparoscopically, and conversion occurred in one patient (6%). In the laparoscopic group, eight (47%) tumors were malignant compared to six (43%) in the open group. Operative times averaged 188 min for the minimally invasive approach and 305 min for the open approach (p = 0.02). Length of stay was 25 days (range 8–82) for the laparoscopic group compared to 20 days (range 6–63; p > 0.05). Overall morbidity and fistula rates ranged from 67 to 24% in the laparoscopic group to 69 to 38% in the open group (p > 0.05). There were no postoperative mortalities. The average follow-up was 63 months for the open group and 33 months for the laparoscopic group. The overall actuarial survival rates were both 90% at 5 years.

Conclusions

Laparoscopic resection of benign and malignant PENs has similar overall complication and 5-year survival rates as the open technique; however, the laparoscopic approach is associated with shorter operative times.

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Acknowledgments

Andrew A. Gumbs, M.D., was supported by a fellowship grant from KARL STORZ GmbH, KG, Tuttlingen, Germany (2006–2007). This work was supported by grants from the Association pour la Recherche contre le Cancer (ARC) of France and the Philippe Foundation in Paris, France.

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Authors and Affiliations

  1. Department of Medical and Surgical Digestive Diseases, Institut Mutualiste Montsouris, Université René Descartes Paris V, 42 Boulevard Jourdan, Paris, 75014, France

    Andrew A. Gumbs, Philippe Grès, Fabio Madureira & Brice Gayet

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  1. Andrew A. Gumbs
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  2. Philippe Grès
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  3. Fabio Madureira
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  4. Brice Gayet
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Correspondence to Brice Gayet.

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Gumbs, A.A., Grès, P., Madureira, F. et al. Laparoscopic vs open resection of pancreatic endocrine neoplasms: single institution’s experience over 14 years. Langenbecks Arch Surg 393, 391–395 (2008). https://doi.org/10.1007/s00423-007-0255-5

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  • DOI: https://doi.org/10.1007/s00423-007-0255-5

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