Enucleation versus standard pancreatic resection for benign lesions and borderline tumors: a comparative study

Abstract

Background: Enucleation of pancreatic benign lesions and borderline tumors, compared with standard pancreatic resection, may avoid postoperative impairment of the metabolic pancreatic functions. However, its influence on postoperative morbidity and disease recurrence seems obscure. Therefore, the choice between both approaches remains controversial. Objective: To evaluate the outcome of enucleation compared with standard pancreatic resection (SPR) of pancreatic benign lesions and borderline tumors among patients presented to Sohag University Hospital. Patients and Methods: Adult patients who underwent enucleation (group A) versus standard resections (group B) of pancreatic benign lesions and borderline tumors at Sohag University Hospital (June 2017 - May 2021) were prospectively enrolled. Both surgical techniques were compared regarding their influence on postoperative metabolic functions of the pancreas, surgical complications, and disease recurrence. Results: Sixteen patients (eight per group) with comparable gender and age distribution were eligible. Group A had significantly shorter operative time, lower amounts of intra-operative blood loss and less transfusions compared to group B. Likewise, patients in group A exhibited significantly reduced severity of surgical complications, including postoperative pancreatic fistula, and required significantly shorter periods of hospital stay. The incidence of new onset diabetes mellitus and pancreatic exocrine insuffficiency were significantly lower among patients in group A compared with those in group B. During follow-up, no recurrence was found in both groups. Conclusion: It could be concluded that enucleation of pancreatic benign lesions and borderline tumors preserves pancreatic metabolic functions, reduces postoperative morbidity and confers satisfactory oncologic outcome.