Pancreatic Function Can Be Maintained Following Removal of Benign Tumors

A pioneering surgical technique enables extirpation of benign tumors of the pancreas, preserving the organ's function to the maximum.

A team of surgeons at the University Hospital of Navarra (Pamplona, Spain) developed the new technique, called laparoscopic middle pancreatectomy (LMP), which enables the removal of benign or scant pancreatic tumors while preserving the function of the organ, and significantly reducing the number of possible complications and the hospitalization period. The tumors targeted are mainly neuroendocrine or cystic tumors of the pancreas that are benign or scant, and that have a highly localized malignant potential. By extirpating the minimum portion possible of the pancreas, the risk of the patient developing intolerance to glucose or diabetes is avoided, as well as any digestive problems that may arise from the lack of pancreatic enzymes. Following the LMP, an anastomosis of the pancreatic duct with the intestine is carried out using roux-en-Y duct-to-mucosa pancreaticojejunostomy; this joining to the intestine is necessary for the pancreas to continue secreting its juices. Hospitalization period is reduced from an average of ten days with the conventional open procedure to four days with laparoscopy. The researchers stress, however, that LMP is not suitable for tumors with poorer prognosis, where it is paramount to operate radically in order to avoid a future regeneration of the tumor. The technique was described in the June 2008 issue of the journal Annals of Surgery.

"This technique has been recognized as a feasible procedure that reduces complications and hospitalization periods, in a highly specific pancreatic pathology,” said technique codeveloper Fernando Pardo, M.D., director of the department of hepato-bilio-pancreatic surgery. "The main achievement is having managed to devise a laparoscopic surgery technique for operations which to date has only been possible through open surgery. This new laparoscopic method is much less invasive and enables a large part of the gland to be conserved, and thus avoids the appearance of postoperative diabetes.”

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University Hospital of Navarra