Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Dec 1;110(12):8250-8255.
doi: 10.1097/JS9.0000000000002143.

Minimally invasive versus open surgery for nonfunctioning pancreatic neuroendocrine tumors: a systematic review and meta-analysis

Kongyuan Wei  1   2   3 , Qingyong Zheng  4   5 , Luying Cheng  4   5 , Wei Li  1   2 , Anna Nießen  3   6 , Faik G Uzunoglu  6 , Felix Nickel  3   6 , Jinhui Tian  4   5 , Zheng Wang  1   2 , Thilo Hackert  6
Affiliations
Meta-Analysis

Minimally invasive versus open surgery for nonfunctioning pancreatic neuroendocrine tumors: a systematic review and meta-analysis

Kongyuan Wei et al. Int J Surg. .

Abstract

Introduction: Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) have been diagnosed increasingly often but still represent rare pancreatic neoplasms. Surgery is a potentially curative approach for patients with NF-PNETs. In recent years, minimally invasive surgery (MIS) has been applied more frequently for surgical resection of NF-PNETs. The evidence for using MIS for NF-PNETs is still being determined and controversial.

Materials and methods: PubMed, Cochrane Library, and the Web of Science database were searched systematically from its inception to July 2023. All studies comparing MIS versus open surgery (OPS) of NF-PNETs were included. The primary outcomes were the incidence of overall postoperative complications and pancreas-specific complications [postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE)]. The secondary measures were duration of operation, intraoperative blood loss, and length of postoperative hospital stay. Pooled results are presented as odds ratios (OR) or mean difference (MD) with a 95% CI.

Results: Five observational studies with a total of 1178 patients were included in the final analysis. The meta-analysis indicated that MIS attained less intraoperative blood loss (MD=-58.59, 95% CI [-92.76 to -24.41], P<0.01) and shorter length of hospital stay (MD=-3.07, 95% CI [-5.28 to -0.87], P<0.01) in contrast to open surgery for NF-PNETs. There were no significant differences concerning operative time (MD=52.04, 95% CI [-8.74 to 112.81], P=0.67), overall postoperative complications (OR=0.78, 95% CI [0.59-1.03], P=0.08), POPF (OR=0.99, 95% CI [0.66-1.47], P=0.94), and DGE (OR=0.58, 95% CI [0.58-1.42], P=0.67).

Conclusions: This study demonstrates that minimally invasive surgery for NF-PNETs is safe and associated with a considerably shorter postoperative hospital stay. Further studies are needed to verify the evidence.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Literature screening process.
Figure 2
Figure 2
Meta-analysis results of dichotomous data. (A) Postoperative complications; (B) Severe complications; (C) POPF; (D) DGE; (E) Recurrence. DGE, delayed gastric emptying; POPF, postoperative pancreatic fistula.
Figure 3
Figure 3
Meta-analysis results of dichotomous data. (A) Operation time; (B) intraoperative blood loss; (C) length of postoperative stay.
See this image and copyright information in PMC

References

    1. Dasari A, Shen C, Halperin D, et al. . Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 2017;3:1335–1342. - PMC - PubMed
    1. Tsilimigras DI, Pawlik TM. Pancreatic neuroendocrine tumours: conservative versus surgical management. Br J Surg 2021;108:1267–1269. - PubMed
    1. Thuillier, LiberiniV P, Grimaldi S, et al. . Prognostic value of whole-body PET volumetric parameters extracted from 68Ga-DOTATOC PET/CT in well-differentiated neuroendocrine tumors. J Nucl Med 2022;63:1014–1020. - PubMed
    1. Calomino N, Poto GE, Carbone L, et al. . Neuroendocrine tumors’ patients treated with somatostatin analogue could complicate with emergency cholecystectomy. Ann Ital Chir 2023;94:518–522. - PubMed
    1. Morken, Langer S, SundlövA SW, et al. . Phase II study ofeverolimus and temozolomide as first-line treatment in metastatic high-grade gastroenteropancreatic neuroendocrine neoplasms. Br J Cancer 2023;129:1930–1939. - PMC - PubMed

MeSH terms

Supplementary concepts