0073 Endo Video
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.