Enucleation shows trade-offs versus Whipple for pancreatic head tumors

This multicenter retrospective cohort study with propensity matching compared enucleation to pancreatoduodenectomy in 434 patients with benign or low-grade pancreatic head or uncinate process tumors. The study reported higher clinically relevant postoperative pancreatic fistula rates after enucleation, but fewer major complications, less delayed gastric emptying, shorter hospital stay, higher global health status scores, lower new-onset diabetes, and higher return to work; the complication advantage was greatest for tumors 2.5 cm or smaller. The authors note residual tumor size imbalance after matching and call for prospective confirmation.

Most relevant for: Patients with benign or low-grade malignant tumors of the pancreatic head or uncinate process being considered for pancreatic resection.

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