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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Minimally invasive versus open pancreatic surgery in patients with multiple endocrine neoplasia type 1

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  • Caroline López-López - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland
  • Max Benjamin Albers - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland
  • Carmen Bollmann - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland
  • Jerana Manoharan - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland
  • Jens Waldmann - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland
  • Volker Fendrich - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland
  • Detlef Klaus Bartsch - Klinik der Philipps-Universität Marburg, Abteilung für VTG-Chirurgie, Marburg, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch493

doi: 10.3205/16dgch493, urn:nbn:de:0183-16dgch4939

Published: April 21, 2016

© 2016 López-López et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: The role of minimally invasive pancreatic surgery for pancreatic neuroendocrine neoplasms (pNENs) in patients with multiple endocrine neoplasia type 1 (MEN1) is not well defined. The aim of this study was to compare the outcome of minimally invasive versus open pancreatic resections in patients with MEN1.

Materials and methods: Prospectively collected data of MEN1 patients who underwent a primary distal pancreatic resection and/or enucleation for nonfunctioning pNENs or insulinoma were retrospectively analyzed regarding the outcome of minimally invasive or open pancreatic resections.

Results: Thirty-three patients underwent primary pancreatic resection for either organic hyperinsulinism (n=9, 27%) or non-functioning pNENs >1cm in size (n=24, 73%) between 1987 and 2015. Twenty-one (64%) patients underwent an open surgical (group 1) and 12 patients (36%) a minimally invasive approach, either laparoscopic (n=8) or robotic-assisted (n=4)(group2). Both groups were comparable regarding age, gender, number and size of pancreatic tumors. In both groups the hyperinsulinism of all patients (9/9,100%) could be cured and all NF-pNENs >1cm could be resected. Group 2 had a significant shorter operative time (200 vs. 260 minutes; p = 0.036), less intraoperative blood loss (120 vs. 280ml; p <0.001) and a shorter hospital stay (11 vs. 15.5 days; p= 0.034). The rate of patients with postoperative complications, especially postoperative pancreatic fistulas, was not different between groups (62% group 1 vs. 67% group 2, p = 0.74).

Conclusion: Minimally invasive distal pancreatic resections and enucleations are feasible and safe in MEN1 patients with insulinoma or non-functioning pNENs.