ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1666758
This article is part of the Research TopicAdvancements in Therapeutic Strategies for Pancreatic Cancer: Challenges and OpportunitiesView all articles
Laparoscopic Enucleation: A Safe and Feasible Treatment Option for Large (≥4cm) Benign or Low-grade Malignant Pancreatic Tumors
Provisionally accepted
- 1Qilu Hospital of Shandong University, Jinan, China
- 2Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- 3Zibo Central Hospital, Zibo, China
- 4Qilu Hospital, Shandong University, Jinan, China
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Background: The optimal surgical approach for large benign or low-grade malignant pancreatic tumors is controversial. The objective of this study was to evaluate the safety and feasibility of laparoscopic enucleation (LapEN) for large pancreatic tumors (≥4cm). Methods: Patients who met the inclusion criteria at Qilu Hospital of Shandong University from January 2015 to May 2022 were retrospectively analyzed. First, the safety and feasibility of LapEN procedure were evaluated based on tumor diameter (≥4cm or not). And then, we further compared the efficacy between LapEN and standard pancreatectomy [laparoscopic pancreaticoduodenectomy (LPD)/ laparoscopic distal pancreatectomy (LDP)] in patients with large tumors (≥4cm). Results: Compared with patients with small tumors who underwent LapEN, there was no significant difference in rates of perioperative adverse events and postoperative complications in patients with large tumors who underwent LapEN, only postoperative hospital stays were prolonged. Among patients with large pancreatic tumors, comparison with standard pancreatectomy, LapEN achieved shorter operative time [(LapEN vs LPD: 160.0±41.4vs 396.8±92.4 min, P<0.001); (LapEN vs LDP: 132.5±53.0 vs 223.1±67.7 min, P<0.001)] and less blood loss {[ LapEN vs LPD: 50 ml (range, 10-400 ml) vs 300 ml (range, 50-1000 ml), P<0.001]; [LapEN vs LDP: 40 ml (range, 5-300 ml) vs 150 ml (range, 20-1000 ml), P=0.001]}. Particularly for large pancreatic head tumors, LapEN was superior to LPD in other terms of conversion rate, postoperative hospital stays, duration of fasting, pain score, and red blood cell transfusion rate. Conclusions: LapEN is a safe and feasible treatment option for large benign or low-grade malignant pancreatic tumors.
Keywords: Pancreatic tumor, Laparoscopic enucleation, Organ-sparing Procedure, tumor size, Pancreatic Fistula, Postoperative Complications
Received: 15 Jul 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Li, Yu, Guo, Wu, Xu, Wei and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Benzun Wei, Zibo Central Hospital, Zibo, China
Lei Wang, Qilu Hospital, Shandong University, Jinan, China
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