Islet Cell Tumor Surgery
Surgery for pancreatic islet cell tumors
Enucleation of pancreatic islet cell tumors
Many functional pancreatic islet tumors such as insulinoma and gastrinoma are small tumors usually less than 1 to 2cm. Furthermore the tumors are often on the surface of the pancreas. The tumors have a lining around them that separates them from the pancreas.
An operation called enucleation is often performed for these tumors. In this operation the tumor is shelled out from the pancreas without removing any pancreatic tissue. We have developed a laparoscopic technique for this operation. This procedure avoids the operations described below which are longer associated with removal with of pancreatic tissue and require longer periods of recovery.
Laparoscopic enucleation of a pancreatic islet cell tumor also allows rapid recovery, early discharge from hospital and early return to work.
Open and laparoscopic Distal Pancreatectomy
We offer open and laparoscopic distal pancreatectomy for endocrine and cystic tumors of the body and tail pancreas. Endocrine and cystic tumors of the pancreas are associated with an excellent outcome and are often benign or associated with a very low grade malignancy. During this procedure two half inch incisions are made and a hand-access device is utilized to perform the surgery. The hand-access device incision is about 2 to 2.5 inches long.Hand-access devices are a major advancement in laparoscopic surgery and allows the surgeon to place a hand into the abdomen during the surgical procedure.
Patient who undergo laparoscopic distal pancreatectomy have less pain, rapid recovery and early discharge from the hospital compared to open distal pancreatectomy. Our average hospital stay for this procedure is about two days.
Laparoscopic distal pancreatectomy is offered to patients in whom the tumor is thought to be benign (not cancerous) and is smaller than than 10cm. In patients with very large tumors or if cancer is suspected, a standard open surgical incision is made to remove the tumor.
For patients with a neuroendocrine tumors in the head of the pancreas, a whipple operation is required. We offer both the standard open surgical method and a laparoscopic technique that we have developed for the whipple operation. At present the laparoscopic whipple operation at USC is offered to patients with chronic pancreatitis, cystic tumors of the pancreas and neuroendocrine tumors of the pancreas. The Whipple operation is performed laparoscopically utilizing the laparoscopic hand-access device. Patients will have three half inch incisions and a hand-access device incision that is approximately 2 to 2.5 inches long.
Central pancreatectomy is a complex operation performed on the pancreas by only a few surgeons in the USA in selected patients with a pancreatic tumor in the neck of the pancreas. The procedure provides localized removal of the tumor in this area and allows preservation of the body and tail of the pancreas that would otherwise be removed as part of the distal pancreatectomy that is usually performed for these tumors. In selected patients we offer a laparoscopic approach for this procedure.