Laparoscopic resections for pancreatic neuroendocrine tumors: case series and discussion

Abstract

Neuroendocrine tumor of the pancreas (pNET) is a wide-spread oncological disease, and its treatment is a widely discussed topic in modern pancreatology. Functioning pNET mainly manifest with hormonal hypersecretion syndrome (accordingly to the type of hormone), whereas nonfunctioning tumors may not produce any symptoms and remain unnoticed, complicating the diagnosis and postponing medical care. Course of the disease and patient’s prognosis largely depend on the stage of the disease and tumor histology. Higher tumor grade, lymph node and liver metastasis, and a larger primary tumor generally portend relatively poor survival. Prognosis of the patients with pNET improves substantially when the disease has been diagnosed and treated on the early stages. Endocrine testing, imaging modalities among which CT, MRI and endoscopic ultrasound are considered most useful; and histological evidence are all required to accurately diagnose pNETs. Recently an “aggressive” approach to pNET treatment has become most popular in academic centers throughout the world. Surgical resection of the tumor is considered the most effective treatment option and a gold treatment standard. Laparoscopic pancreatic resections also play major role in the treatment of pNET. Laparoscopic approach is safe and effective modality, so the number of laparoscopic operations has been growing last years. Among the benefits of minimally invasive surgery are lesser postoperative pain, shorter hospital length of stay, better cosmetic appearance and shorter disease-related inability of work period. In these case series characteristics of the early diagnosis and successful laparoscopic surgical treatment for the patients with pNET of the right anatomical segment of the pancreas are described.