Parenchyma-sparing pancreatectomy for solid pseudopapillary neoplasm of the pancreas: A propensity-matched analysis.
Parenchyma-sparing pancreatectomy linked to higher overall complication rate than conventional resection.
Parenchyma-sparing pancreatectomy for solid pseudopapillary neoplasm of the pancreas: A propensity-matched analysis.
The oncological equivalence of parenchyma-sparing pancreatectomy versus conventional resection for solid pseudopapillary neoplasm of the pancreas remains debated.
This study compares perioperative and long-term outcomes between these approaches.
A retrospective study was conducted on patients undergoing solid pseudopapillary neoplasm resection at a high-volume center between June 2002 and August 2024.
Complications occurred in 60% of parenchyma-sparing cases versus 37% of conventional resections.
Among 261 patients, 49 (18.8%) had enucleations, 28 (10.7%) had central pancreatectomies, 2 (0.8%) had duodenum-preserving pancreatic head resections, and 182 (69.7%) underwent conventional resection.
Parenchyma-sparing pancreatectomy demonstrated reduced blood loss (100 vs 200 mL, P < .001), shorter operative time (3.0 vs 5.0 hours, P < .001), and shorter hospital stay (9 vs 10.5 days, P = .008).
Long-term recurrence-free survival was equivalent between groups (P = .971), with resection type not predicting recurrence.
Parenchyma-sparing pancreatectomy for solid pseudopapillary neoplasm offers equivalent oncological control and superior perioperative efficiency compared with conventional resection, albeit with a higher incidence of manageable postoperative pancreatic fistula.
Given the potential for preserved endocrine/exocrine function, parenchyma-sparing pancreatectomy is a viable strategy for carefully selected patients when performed by experienced surgeons.