Laparoscopic pancreatectomy for solid pseudo-papillary tumors of the pancreas is a suitable technique; our experience with long-term follow-up and review of the literature.
BACKGROUND
Solid pseudopapillary tumors (SPTs) are rare pancreatic neoplasms of low malignant potential that occur mainly in young women. Only 17 cases of SPT treated laparoscopically have been published in the literature and long-term follow-up data are still lacking.


METHODS
Retrospective analysis of ten patients (8 women, 2 men; mean age, 25.4 years) (DS: 12.1; minimum 11, maximum 51) who underwent laparoscopic distal pancreatectomy with a definitive histological diagnosis of SPT. Long-term follow-up data were collected.


RESULTS
The average tumor size was 43.8 mm (minimum 20, maximum 65 mm). The mean operative time was 177.5 minutes (DS: 53.7; minimum 120, maximum 255). In all, five patients underwent distal splenopancreatectomy; five patients underwent spleen-preserving distal pancreatectomy of whom three with splenic vessel preservation and two with the Warshaw technique. The conversion rate was nil and no case of perioperative mortality was recorded. The mean hospital stay was 7 days (DS: 2.7; minimum 4, maximum 12). Six patients had an uneventful postoperative course and four had postoperative complications. Two of them underwent reoperation, and the other two had nonsurgical complications. After a median follow-up of 47 (range, 5-98) months, all patients were alive and disease-free.


CONCLUSIONS
Laparoscopic pancreatic resection is a safe and feasible procedure that could become the treatment of choice for patients affected by pancreatic SPT. Distal pancreatectomy should be performed, if possible, with spleen-preserving technique, especially in young patients. To avoid metastatic spread, laparoscopic or laparotomic biopsy should not be performed in patients affected by SPT.
Cavallini
Alvise
A
Surgical Department, Chirurgia Generale B-Policlinico GB Rossi-Borgo Roma, Verona University, Verona, Italy.
Alvise
Cavallini
C
Butturini
Giovanni
G
Giovanni
Butturini
B
Daskalaki
Despoina
D
Despoina
Daskalaki
D
Salvia
Roberto
R
Roberto
Salvia
S
Melotti
Gianluigi
G
Gianluigi
Melotti
M
Piccoli
Micaela
M
Micaela
Piccoli
P
Bassi
Claudio
C
Claudio
Bassi
B
Pederzoli
Paolo
P
Paolo
Pederzoli
P
D018292:Cystadenoma, Papillary / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D012196:Review Literature as Topic; D015996:Survival Rate; D016896:Treatment Outcome