The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours

Curr Treat Options Oncol. 2021 Feb 27;22(4):27. doi: 10.1007/s11864-021-00824-5.

Abstract

Pancreatic neuroendocrine tumours (PNETs) are a rare and heterogeneous group of tumours with various clinical manifestations and biological behaviours. They represent approximately 2-4% of all pancreatic tumours, with an incidence of 2-3 cases per million people. PNETs are classified clinically as non-functional or functional, and pancreatic resection is recommended for lesions greater than 2 cm. The surgical approach can involve "typical" and "atypical" resections depending on the number, size and location of the tumour. Typical resections include pancreaticoduodenectomy, distal pancreatectomy enucleation and, rarely, total pancreatectomy. Atypical resections comprise central pancreatectomies or enucleations. Minimally invasive pancreatic resection has been proven to be technically feasible and safe in high-volume and specialized centres with highly skilled laparoscopic surgeons, with consolidated benefits for patients in the postoperative course. However, open and minimally invasive pancreatic surgery remains to have a high rate of complications; there is no specific technical contraindication to minimally invasive pancreatic surgery, but an appropriate patient selection is crucial to obtain satisfactory clinical and oncological outcomes.

Keywords: Laparoscopy; Minimally invasive surgery; Pancreatic surgery; Pnets.

Publication types

  • Review

MeSH terms

  • Clinical Decision-Making
  • Combined Modality Therapy
  • Cost-Benefit Analysis
  • Disease Management
  • Health Care Costs
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Minimally Invasive Surgical Procedures / methods
  • Neoplasm Staging
  • Neuroendocrine Tumors / pathology*
  • Neuroendocrine Tumors / surgery*
  • Pancreatectomy / methods
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications
  • Prognosis
  • Treatment Outcome