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World J Gastrointest Oncol. Jul 15, 2022; 14(7): 1227-1238
Published online Jul 15, 2022. doi: 10.4251/wjgo.v14.i7.1227
Prospects and applications of enucleation in solid pseudopapillary neoplasms of the pancreas
Rui Wang, Jing Li, Chun-Lu Tan, Xu-Bao Liu, Yong-Hua Chen
Rui Wang, Chun-Lu Tan, Xu-Bao Liu, Yong-Hua Chen, Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610037, Sichuan Province, China
Jing Li, Department of Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610037, Sichuan Province, China
Author contributions: Wang R and Li J contributed equally to this work; Chen YH and Liu XB conceptualized and designed the manuscript; Wang R, Li J, and Tan CL drafted the manuscript; all authors revised the manuscript for important intellectual content; Liu XB and Chen YH supervised the work of the manuscript; Liu XB obtained research funding; all authors have read and approved the final manuscript.
Supported by the Key Research and Development Projects in Sichuan Province, No. 2019YFS0043; and the 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, No. ZY2017302-1.3.5.
Conflict-of-interest statement: The authors have no conflicts of interest to declare. No benefits in any form were received or will be received from a commercial party related directly or indirectly to the subject of this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Hua Chen, MD, PhD, Adjunct Associate Professor, Department of Pancreatic Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610037, Sichuan Province, China. chenyonghua2007@163.com
Received: March 13, 2022
Peer-review started: March 13, 2022
First decision: April 17, 2022
Revised: April 30, 2022
Accepted: June 21, 2022
Article in press: June 21, 2022
Published online: July 15, 2022
Processing time: 121 Days and 13.7 Hours
Abstract

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare, low-grade, malignant neoplasms that are mostly seen in young women in the second and third decades of life and are quite uncommon in children. Standard resection for benign and borderline neoplasms of the pancreas is associated with a substantial risk of postoperative morbidity and long-term functional impairment, whereas enucleation leads to less morbidity and preserves healthy parenchyma as well as exocrine and endocrine function. Enucleation of SPNs has been increasingly reported to be feasible and safe for preserving the normal physiological function of the pancreas, especially in teenagers and children. This review summarizes findings published in recent years on the enucleation of SPNs as well as potential future developments and directions. Enucleation has undoubtedly come to stay as an alternative surgical procedure for SPNs. However, many questions remain unresolved, and future directions toward the best surgical indication, the prevention and intervention of complications, especially pancreatic fistula, intraoperative resection margin safety assessment, and long-term oncology prognosis remain to be evaluated and should be explored in future clinical trials.

Keywords: Solid pseudopapillary neoplasm; Enucleation; Pancreatic tumor; Distal pancreatectomy; Pancreaticoduodenectomy

Core Tip: Enucleation of solid pseudopapillary neoplasms (SPNs) has been increasingly reported to be feasible and safe for preserving pancreatic function, especially in teenagers and children. This review summarizes findings published in recent years on the enucleation of SPNs as well as potential future developments and directions. Enucleation has undoubtedly come to stay as an alternative surgical procedure for SPNs. However, many questions remain unresolved, and future directions toward the best surgical indication, the prevention and intervention of complications, especially pancreatic fistula, intraoperative resection margin safety assessment, and long-term oncology prognosis remain to be evaluated.