EARLY EXPERIENCE WITH LAPAROSCOPIC RESECTIONS OF ISLET-CELL TUMORS

Background. Diagnostic laparoscopy and laparoscopic ultrasonography ha ve been applied recently for diagnosis and localization of islet-cell tumors. A further step was taken by preforming resection of these tumo rs with laparoscopic techniques. Methods and Results. We studied a ret rospective series of 12 patients operated on with laparoscopic techniq ues since January 1992. The seven female and five male patients had a mean age of 43 years. The mean tumor size was 3 cm. Thirty-six percent of the tumor site could not be identified before operation. Eight pat ients underwent planned laparoscopic distal pancreatectomy (five insul inomas, two gastrinomas, and one unknown origin), and four underwent p lanned laparoscopic enucleation (one insulinoma and three unknown orig in). Of the eight distal procedures, three had conversions (one inabil ity to localize the tumor and two metastatic gastrinomas). Average ope rating time was 4.5 hours, with an average hospital stay of 5 days. Of the four exploration for possible enucleation, one was performed and one was converted to a Whipple procedure for nesidioblastoma of the he ad of the pancreas. The other two had negative explorations. The succe ssful enucleation of an insulinoma of the anterior body of the pancrea s was performed in 3 hours, and the hospital stay was 4 days. No recur rence was seen in the enucleated or distal pancreatectomy group in fol low-up (15 to 38 months). Conclusions. Laparoscopic enucleation or res ection of benign islet tumors results in a shorter hospital recovery a nd is a good alternative to open surgery.