Laparoscopic parenchyma-sparing resections for solid pseudopapillary tumors located in the head of pancreas 

Background: Solid pseudopapillary tumor (SPT) of pancreas is a rare low-grade malignant tumor. We aim to identify the safety and feasibility of laparoscopic parenchyma-sparing pancreatectomy for SPT located in the head of pancreas. Methods: From July 2014 to February 2022, 62 patients with SPT located in the head of pancreas were operated laparoscopically in two institutions. These patients were divided into two groups basing on the operative strategy: laparoscopic parenchyma-sparing pancreatectomy (27 patients, group 1) and laparoscopic pancreaticoduodenectomy (35 patients, group 2). Data were retrospectively collected and analyzed in terms of demographic, peri-operative variables, and long-term follow-up outcomes. Results: The demographic characteristics of patients in two groups were comparable. Compared with that in group 2, the patients in group 1 required fewer operative time (263.4 ± 37.2 min vs. 332.7 ± 55.6 min, p < 0.001), and suffered from less blood loss (105.1 ± 36. ml vs. 188.3 ± 150.7 ml, p < 0.001). No patients in group 1 suffered from tumor recurrence or metastases. However, 1 (2.5%) patient in group 2 suffered from liver metastases. Conclusion: Laparoscopic parenchyma-sparing pancreatectomy is safe and feasible for SPT located in the head of pancreas, with favorable long-term functional and oncological results.