Laparoscopic surgery for solid pseudopapillary tumor of the pancreas.

Afridi, Shabbir A; Kazaryan, Airazat M; Marangos, Irina Pavlik; Røsok, Bård I; Fretland, Åsmund A; Yaqub, Sheraz; Edwin, Bjørn

BACKGROUND AND OBJECTIVES Solid pseudopapillary tumors of the pancreas are rare and occur most frequently in young women. They have an uncertain pathogenesis and unclear clinical behavior. Our aim was to evaluate the clinical presentation of solid pseudopapillary tumors and assess the efficacy of treatment with minimally invasive surgery. METHODS From March 1997 to February 2011, 13 of 273 patients who underwent laparoscopic procedures on the pancreas were found to have solid pseudopapillary tumors. There were 12 female patients and 1 male patient. The median age was 21 years (range, 15-77 years). Abdominal pain was the most common presenting symptom (n=9). Tumors were incidentally found in 3 patients on computed tomography scans obtained for other reasons. RESULTS Enucleation of the tumor was performed in 4 patients, including 3 in whom the tumor was located in the head of the pancreas. Eight patients underwent distal pancreatectomy with splenectomy, whereas spleen-preserving distal pancreatectomy was performed in one case. The median tumor size was 6 cm (range, 1.5-11 cm), the median operative time was 197 minutes (range, 68-320 minutes), and the median blood loss was 50 mL (range, <50-750 mL). Distal resections were performed with a linear stapler. Four patients had postoperative complications. The median length of hospital stay was 5 days (range, 2-12 days). During a median follow-up period of 11 months (range, 3-121 months), no local recurrences or distant metastases were found. CONCLUSION Laparoscopic resections and enucleations of solid pseudopapillary tumors of the pancreas can be performed safely and with adequate resection margins even if the tumors are located in the head of the organ.