Short-term outcomes of laparoscopic and robotic limited resections of pancreatic neuroendocrine tumours of the uncinate process: Report of six cases and review of the literature

Teik-Wen Lim; Hwee-Leong Tan; Ek-Khoon Tan; Peng-Chung Cheow; Brian Kim Poh Goh

doi:10.4103/jmas.jmas_335_23

Short-term outcomes of laparoscopic and robotic limited resections of pancreatic neuroendocrine tumours of the uncinate process: Report of six cases and review of the literature

J Minim Access Surg. 2024 May 10. doi: 10.4103/jmas.jmas_335_23. Online ahead of print.

Authors

Teik-Wen Lim¹, Hwee-Leong Tan^{1

2}, Ek-Khoon Tan^{1

2}, Peng-Chung Cheow^{1

2}, Brian Kim Poh Goh^{1

2}

Affiliations

¹ Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre, Singapore.
² Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore.

PMID: 38726970
DOI: 10.4103/jmas.jmas_335_23

Abstract

Introduction: Minimally invasive surgery (MIS) for limited resections for pancreatic uncinate lesions is not widely performed but can adequately treat benign or low-grade malignant lesions. The aim of this study was to evaluate the short-term outcomes of MIS-limited pancreatic resections for patients with suspected pancreatic neuroendocrine tumours (PNETs).

Patients and methods: This was a retrospective study of six consecutive patients who underwent MIS for PNET within a single institution between 2017 and 2022.

Results: Six patients underwent limited pancreas-preserving MIS of the uncinate process (uncinectomy or enucleation), of which two were performed through the robotic approach and four through laparoscopic approach. The median operation time was 212.5 (175-338.75) min, and the median blood loss was 50 (50-112.5) ml. The median post-operative hospital length of stay was 5.5 (3.75-11.5) days. Two patients (33.3%) had major post-operative morbidities (Clavien-Dindo ≥Grade 3). There were no open conversions or post-operative mortalities. Five patients had histologically proven Grade 1 neuroendocrine tumours. One was T2 and four were T1.

Conclusions: This study suggests that limited MIS resections of pancreatic uncinate PNETs are a feasible procedure with good patient outcomes. It offers a safe alternative to radical surgical resections like pancreatoduodenectomies in selected patients with low-grade malignant or benign tumours.