title: Laparoscopic distal pancreatectomy for neuroendocrine tumors of the pancreas.
abstract: Although neuroendocrine tumors of the pancreas are traditionally managed by laparotomy, these rare neoplasms may be amenable to laparoscopic surgical resection. We present our experience with laparoscopic distal pancreatectomy in two such patients, and discuss the operative technique with emphasis on organ preservation. Two female patients aged 63 and 69 years presented with clinical and biochemical features of an insulinoma and a vasoactive intestinal peptide secreting tumor (VIPoma), and were found on cross-sectional imaging to have 1.2-cm and 4.5-cm solitary tumors in the tail of the pancreas. They underwent laparoscopic distal pancreatectomy with and without preservation of splenic vessels and spleen respectively. Both procedures were completed laparoscopically. The operating time was 180 and 210 minutes respectively. There were no postoperative complications. The postoperative hospital stay was 4 and 14 days respectively. Histology revealed a benign insulinoma and a malignant VIPoma with lymph node metastases respectively. Laparoscopic distal pancreatectomy for neuroendocrine tumors of the pancreas may be accomplished safely, with preservation of the spleen and splenic vessels in benign disease, and with benefits to the patients in terms of postoperative recovery.
authors.affiliation: Department of Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. Bammori@aol.com
authors.forename: Basil J
authors.initials: BJ
authors.lastname: Ammori
authors.forename: Yesar
authors.initials: Y
authors.lastname: El-Dhuwaib
authors.forename: Pedro
authors.initials: P
authors.lastname: Ballester
authors.forename: Titus
authors.initials: T
authors.lastname: Augustine
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D003969:Vipoma / Q000000981:diagnostic imaging / Q000601:surgery*