Laparoscopic Excision of Pancreatic Neuroendocrine Tumor

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LAPAROSCOPIC EXCISION OF PANCREATIC NEUROENDOCRINE TUMOR

H. Kais, Z. Halpern, A. Halevy

Division of surgery, Assaf Harofeh medical center, Israel

AIMS: to evaluate the benefit of laparoscopy in excision of pancreatic neuroendocrine tumors (PNET).

METHODS: Two patients with PNET were operated on. One patient with a symptomatic insulinoma in the body of the pancreas, and the second patient with a non functional PNET in the head of the pancreas. In both of them laparoscopic excision of the PNET was carried out.

RESULTS: A preoperative localization of both PNET was achieved by CT angio and EUS. Blood tests confirmed the diagnosis of insulinoma in the first case and a non functional tumor in the second patient. Intra operative US was performed, and laparoscopic enucleation was carried out in both patients.

The 2 operations were uneventful. The post operative course was uneventfull for the patient with the non functioning PNET , while the patient with the insulinoma developed a low output pancreatic fistula which took almost two months to close, however the clinical signs of the hypoglycemia were corrected immediately during the operation.

CONCLUSIONS: laparoscopic excision of PNET is feasible and adequate treatment for PNET .One should remember however that pancreatic fistula occurs in almost 30% of patient undergoing laparoscopic excision of these type of neoplasms.