Wang Rui, Li Jing, Tan Chun-Lu, Liu Xu-Bao, Chen Yong-Hua
Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610037, Sichuan Province, China.
Department of Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610037, Sichuan Province, China.
World J Gastrointest Oncol. 2022 Jul 15;14(7):1227-1238. doi: 10.4251/wjgo.v14.i7.1227.
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.
胰腺实性假乳头状肿瘤（SPNs）是一种罕见的、低级别恶性肿瘤，多见于二三十岁的年轻女性，在儿童中极为罕见。胰腺良性和交界性肿瘤的标准切除术与术后较高的发病率风险和长期功能损害相关，而剜除术导致的发病率较低，并能保留健康的实质组织以及外分泌和内分泌功能。越来越多的报道表明，SPNs的剜除术对于保留胰腺的正常生理功能是可行且安全的，尤其是在青少年和儿童中。本综述总结了近年来关于SPNs剜除术的研究结果以及潜在的未来发展和方向。剜除术无疑已成为SPNs的一种替代手术方式。然而，许多问题仍未解决，未来关于最佳手术适应症、并发症（尤其是胰瘘）的预防和干预、术中切缘安全性评估以及长期肿瘤学预后等方向仍有待评估，应在未来的临床试验中进行探索。
