Systematic review and meta-analysis on laparoscopic pancreatic resections for neuroendocrine neoplasms (PNENs)

Expert Rev Gastroenterol Hepatol. 2017 Jan;11(1):65-73. doi: 10.1080/17474124.2017.1253473. Epub 2016 Nov 8.

Abstract

The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. Areas covered: Studies conducted between January 2003 and December 2015 that reported on LPS and open surgery (OPS) were reviewed. The primary outcomes were the rate of post-operative complications and the length of hospital stay (LoS) after laparoscopic and open surgical resection. The rate of recurrence was the secondary outcome. Eleven studies were included with a total of 907 pancreatic resections for PNENs, of whom, 298 (32.8%) underwent LPS and 609 (67.2%) underwent open surgery. LPS resulted in a significantly shorter LoS (p < 0.0001) and lower blood loss (p < 0.0001). The meta-analysis did not show any significant difference in the pancreatic fistula rate, recurrence rate or post-operative mortality between the two groups. Expert commentary: LPS is a safe approach even for PNENs and it is associated with a shorter LoS.

Keywords: Pancreatic surgery; laparoscopic pancreatic resection; laparoscopy; minimally invasive surgery; neuroendocrine neoplasms.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Blood Loss, Surgical
  • Chi-Square Distribution
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / mortality
  • Length of Stay
  • Neoplasm Recurrence, Local
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery*
  • Odds Ratio
  • Pancreatectomy / adverse effects
  • Pancreatectomy / methods*
  • Pancreatectomy / mortality
  • Pancreatic Fistula / etiology
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Risk Factors
  • Time Factors
  • Treatment Outcome