Minimally invasive (laparoscopic and robot-assisted) approach for solid pseudopapillary tumor of the distal pancreas: A single-center experience

Background/purpose: A single-institutional experiences of solid pseudopapillary tumor (SPT) in the distal pancreas were retrospectively reviewed with special reference to a minimally invasive approach. Methods: Thirty-five patients with SPT of the distal pancreas treated during the past 20 years were retrospectively evaluated. We divided the patients into 2 groups based on the surgical approach: the laparoscopic/robot-assisted surgery (LR) group and the conventional open surgery (O) group. We reviewed the chronological changes and characteristics of SPT. A comparative analysis of the two groups (LR vs. O) was conducted in terms of perioperative surgical outcomes. Results: The discovery of relatively small SPTs without symptoms seemed to be increasing (p<0.05). Eleven of the 35 patients were assigned to the LR group. Ten patients were female and 1 was male, and they had a median age of 32 years (range 24-62 years) and a median tumor size of 3.6 cm (range 1-8.5 cm). Eight patients underwent laparoscopic distal pancreatectomy with or without splenectomy, and the remaining 3 underwent robot-assisted central pancreatectomy with pancreaticogastrostomy. In the comparative analysis of the LR and O groups, smaller tumor size, earlier oral intake, and shorter hospital stay, without increasing morbidity, were noted in the LR group (p<0.05). Conclusions: A minimally invasive (laparoscopic/robot-assisted) approach for SPT of the distal pancreas is thought to be more appropriate than and preferable to conventional open surgery in well-selected patients.