Objective: To analyze the safety and effectiveness of minimal invasive surgery treating pancreatic neuroendocrine tumors (pNETs), and to summarize surgical characteristics and share experience. Methods: The clinical data of 80 pNETs treated by a single hospital from January 2015 to December 2019 were retrospectively analyzed. The patients were divided into laparoscopic group and robot group. And surgical procedures included pancreaticoduodenectomy (PD), distal pancreatectomy (DP), central pancreatectomy (CP), and tumor enucleation. Results: Of 80 patients, 76 cases (95%) underwent minimal invasive surgery and 4 cases (5%) changed to open surgery. There were 38 females, with median age of 54.4 (20-80) years and median BMI (17.0-38.0) kg/m(2). Among them, 24 patients (31.6%) underwent PD, 36 patients (47.4%) underwent DP, 8 patients (10.5%) underwent CP and 8 patients (10.5%) received tumor enucleation. The postoperative incidence of grade B/C pancreatic fistula was 35.5%, the incidence of abdominal infection was 10.5%, the postoperative bleeding was 7.9%, and the reoperation rate was 6.6%, without perioperative deaths. There was no significant difference in postoperative complications among different surgical methods, including postoperative pancreatic fistula (P=0.396), postoperative bleeding (P=0.297), postoperative abdominal infection (P=0.339) and reoperation (P=0.396). Conclusions: Surgical resection is an effective treatment for pNETs. pNETs are suitable for minimally invasive surgery with earlier stage and smaller tumor diameter. Minimally invasive surgery for pNETs is safe and feasible, and functional preserving surgery could take into consideration.
目的： 分析微创手术治疗胰腺神经内分泌肿瘤（pNETs）的安全性和有效性，总结其手术治疗的特点和经验。 方法： 回顾性分析2015年1月至2019年12月浙江省人民医院收治的80例pNETs患者的临床资料。按手术路径分为腹腔镜组和机器人组，手术方式包括胰十二指肠切除术（MPD)、胰体尾切除术（MDP)、胰腺中段切除术（CP）和胰腺肿瘤剜除术（MPP）。 结果： 本组80例，其中成功完成微创手术76例（95%），中转开放4例（5%）。76例中女性38例（50%)，中位年龄54.4（20~80）岁，中位体质指数（BMI）24.0（17.0~38.0）kg/m(2)。腹腔镜手术67例（88.2%），机器人手术9例（11.8%）。手术方式如下：胰十二指肠切除术24例（31.6%），胰尾切除术36例（47.4%），胰腺中段切除术和胰腺肿瘤剜除术各8例（10.5%）。术后B/C级胰漏25例（35.5%），腹腔感染8例（10.5%），术后出血6例（7.9%），二次手术5例（6.6%）。无围手术期死亡。不同手术方式组术后并发症差异无统计学意义[术后胰漏（P=0.396）、出血（P=0.297）、腹腔感染（P=0.339）和二次手术（P=0.396）]。 结论： 手术切除是治疗pNETs的有效手段。多数pNETs分级较早，肿瘤直径小，适合微创手术；且微创手术治疗pNETs安全可行；早期手术更可能采用功能保留术式。.
Keywords: Laparoscopy; Neuroendocrine tumors; Pancreatic neoplasms.