Resektionsstrategien beim BD-IPMN-Enukleation oder onkologische Resektion?

Translated title of the contribution: Resection Strategies in BD-IPMN-Enucleation or Standard Resection?

Ilaria Pergolini, Helmut Friess, Ihsan Ekin Demir

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Background The malignant potential and the surgical management of branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) remain controversial. Enucleation (EN), as parenchyma-sparing resections of the pancreas, may be a valuable alternative to standard resections (SR), e.g., Whipple or distal pancreatectomy, for the treatment of BD-IPMN. However, its role is still poorly defined. The objective of this review is to compare indications and postoperative outcomes after pancreatic EN versus SR. Methods A review of the literature was carried out. Short-and long-term postoperative outcomes of both surgical approaches were evaluated. Results EN is associated with shorter operation time and less blood loss than SR. The overall surgical morbidity does not differ between the two approaches. Although EN is less invasive, the development of pancreatic fistula is the most important complication after EN, as several studies have reported a higher rate of pancreatic fistula than after SR. However, the differences between the two procedures are mitigated in high-volume centres. EN more frequently allows the preservation of pancreatic exocrine and endocrine function in comparison to SR and this is the most important advantage of this procedure. Conclusions EN appears to be a safe and effective alternative to treat low-risk BD-IPMN, and allows preservation of endocrine and exocrine function. Moreover, postoperative complications and recurrence rates after EN are comparable to the much more extensive surgical procedures. However, pancreatic EN should be performed by experienced surgeons and, as non-oncological procedure, patients should be very accurately selected. This underlines the importance of treatment in high-volume institutions.

Translated title of the contributionResection Strategies in BD-IPMN-Enucleation or Standard Resection?
Original languageGerman
Pages (from-to)155-159
Number of pages5
JournalZentralblatt fur Chirurgie - Zeitschrift fur Allgemeine, Viszeral- und Gefasschirurgie
Volume147
Issue number2
DOIs
StatePublished - 1 Apr 2022
Externally publishedYes

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