Introducere: Tumorile neuroendocrine ale pancreasului (TNEP) ocupă de la 1 la 2% din patologia pancreatică oncologică,
incidenţa diagnosticării pe parcursul vieţii este de 12-15 cazuri la 1 milion de populaţie.
Scop: Familiarizarea cu cea mai mare experienţă de tratament chirurgical al tumorilor neuroendocrine pancreatice din Ucraina.
Material și metode: În Institutul Naţional de Chirurgie şi Transplantologie din ianuarie 2004 pînă în decembrie 2014 au fost
trataţi 173 pacienţi cu TNEP, la care s-au efectuat 181 intervenţii chirurgicale. Tumori pancreatice neuroendocrine nonfuncţionale
au fost diagnosticate la 103 pacienţi (59,5%), hormonal active – la 70 (40,5%). În cazul TNEP non-funcţionale
predominau procedeele chirurgicale rezecţionale (operaţia Whipple, pancreatectomia stîngă), pentru majoritatea tumorilor
hormonal active s-au utilizat interventii organomenajante (enucleerea tumorii).
Rezultate: Complicaţii postoperatorii s-au dezvoltat la 18,4% pacienţi cu TNEP, cea mai frecventă fiind fistula pancreatică
externă (9,8%). Mortalitatea postoperatorie a constituit 1,2%. Supraviețuirea generală la 5 ani a fost de 82,3%, TNE G1 – 100%,
TNE G2 – 84,3%, carcinom neuroendocrin, CNE G3 – 38,7%.Concluzii: Nivelul complicaţiilor postoperatorii şi a indicatorilor mortalităţii corespunde celorlalte tumori ale pancreasului. Nivelul
supravieţuirii de 5 ani este destul de mare, ceea ce sugerează utilizarea intervenţiilor organomenajante laparoscopice pentru
formele localizate de TNEP. Formele avansate de TNEP nu reprezintă o contraindicaţie pentru tratamentul chirurgical, dar astfel
de cazuri trebuie evaluate în mod individual. Incidenţa relativ mică a TNEP, complexitatea şi importanţa diagnosticului
preoperator pentru alegerea strategiei curative optimale, justifică efectuarea tratamentului acestor pacienţi în centre
specializate.
Introduction: Neuroendocrine tumors of the pancreas (PNET) range from 1 to 2% of pancreatic oncological pathology; the
frequency during lifetime diagnostics is 12-15 cases per 1 million of population.
Aim: Introduce the largest experience of surgical treatment of neuroendocrine tumors of the pancreas in Ukraine.
Material and methods: In the National Institute of Surgery and Transplantology from January 2004 to December 2014 were
treated 173 patients with neuroendocrine tumors of the pancreas, to whom were performed 181 surgeries. Non-functioning
PNET were diagnosed in 103 patients (59.5%), hormone-active were in 70 (40.5%). In non-functioning PNET dominated
resection surgeries (Whipple procedure, left-side pancreatectomy), at hormone-active were performed mostly organ-preserving
surgeries (enucleation of tumor).
Results: Postoperative complications occurred in 18.4% of patients with PNET, the most common complication was external
pancreatic fistula (9.8%). Total postoperative mortality was 1.2%. The overall 5-year survival was 82.3%, NET G1 – 100%, NET
G2 – 84.3%, neuroendocrine carcinoma, NEC G3 – 38.7%.
Conclusions: The level of postoperative complications and mortality indicators complies with all tumors of the pancreas. The
level of the overall 5-year survival is quite high, allowing for organ-preserving and laparoscopic surgeries for localized forms of
PNET. Advance forms of PNET are not a contraindication to surgical treatment, but such cases must be evaluated individually.
Relatively few of occurrences of PNET, the complexity and importance of preoperative diagnostic to choose the optimal
treatments strategy, justifying perform the treatment of these patients in specialized centers.
