Side-branch intraductal papillary
mucinous neoplasms (side-branch IPMN) of the pancreas have a low malignant
potential. The conventional treatment for this lesion, according to location,
if there are signs of possible malignancy, has been pancreaticoduodenectomy
(PD), total pancreatectomy (P), central pancreatectomy (CP) or distal
pancreatectomy (DP).
Despite advances reported in
recent years, standard pancreatectomies still carry a significant postoperative
mortality ranging from 1 % to 4 %. These interventions are also associated with
high postoperative morbidity and long-term disorders such as diabetes [4] and
exocrine insufficiency. Less invasive surgery, including enucleation (EN) and
resection of ucinate process (RUP), has been introduced for management of
benign IPMN to preserve pancreatic function postoperatively and decrease
postoperative mortality and morbidity.
However, recommendations and
reports of postoperative complications and clinical outcomes following these
procedures have been limited. The debate between PR and EN is still a challenge
for surgeons. At our knowledge, this is the first meta-analysis to compare EN
to PR for the treatment of side-branch IPMN.This systematic review aimed to
determine whether the EN is associated or not with a higher risk of mortality
and morbidity compared to PR techniques for side-branch IPMN of the pancreas.
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