微创手术在左胰腺切除方面取得了进展。然而，对于治疗胰腺神经内分泌肿瘤的远端胰腺切除术是否比开放手术有任何优势，仍存在争议。这项回顾性综述检查了 2014 年 1 月至 2018 年 12 月期间在法国 21 个中心针对可切除胰腺神经内分泌肿瘤进行的胰腺切除术。 短期和长期结果根据肿瘤大小、性别、年龄、体重指数、中心和胰腺横断方法，对倾向评分匹配前后进行比较。 在研究期间，274 名患者因胰腺神经内分泌肿瘤接受了左胰腺切除术 [109 名患者接受了远端脾胰切除术， 165 例接受了保留脾脏的远端胰腺切除术[（保留脾血管（n = 97；58.7%）/脾血管切除术（n = 68；41.3%）]。在倾向评分匹配之前，微创手术与较低的胰腺切除率相关。主要发病率 (P = .004)、术后胃排空延迟率较低 (P = .04) 以及“教科书”结果的发生率较高 (P = .04)。经过倾向评分匹配后，分为两组，每组 54 名患者（n = 30 例远端脾胰切除术；n = 78 例保留脾远端胰腺切除术）。微创手术与失血量较少 (P = .05)、主要发病率降低 (6% 对比 24%；P = .02)、胃排空延迟较少 (P = .05) 相关，尽管术后发生率相似瘘管、出血和再次手术 (P > .05)。 5 年总生存率（79% vs. 75%；P = .74）和无复发生存率（10% vs 17%；P = .39）相似。可以安全地建议进行左胰腺切除的微创手术适用于可切除的左胰腺神经内分泌肿瘤患者。微创手术可降低主要并发症的发生率，同时提供可比较的长期肿瘤学结果。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Minimally invasive surgery has gained momentum for left pancreatic resections. However, debate remains about whether it has any advantage over open surgery for distal pancreatectomy for pancreatic neuroendocrine tumors.This retrospective review examined pancreatectomies performed for resectable pancreatic neuroendocrine tumors at 21 centers in France between January 2014 and December 2018. Short and long-term outcomes were compared before and after propensity score matching based on tumor size, sex, age, body mass index, center, and method of pancreatic transection.During the period study, 274 patients underwent left pancreatic resection for pancreatic neuroendocrine tumors [109 underwent distal splenopancreatectomy, and 165 underwent spleen-preserving distal pancreatectomy [(splenic vessel preservation (n = 97; 58.7%)/splenic vessel resection (n = 68; 41.3%)]. Before propensity score matching, minimally invasive surgery was associated with a lower rate of major morbidity (P = .004), lower rate of postoperative delayed gastric emptying (P = .04), and higher rate of "textbook" outcomes (P = .04). After propensity score matching, there were 2 groups of 54 patients (n = 30 distal splenopancreatectomy; n = 78 spleen-preserving distal pancreatectomy). Minimally invasive surgery was associated with less blood loss (P = .05), decreased rate of major morbidity (6% vs. 24%; P = .02), less delayed gastric emptying (P = .05) despite similar rates of postoperative fistula, hemorrhage, and reoperation (P > .05). The 5-year overall survival (79% vs. 75%; P = .74) and recurrence-free survival (10% vs 17%; P = .39) were similar.Minimally invasive surgery for left pancreatic resection can be safely proposed for patients with resectable left pancreatic neuroendocrine tumors. Minimally invasive surgery decreases the rate of major complications while providing comparable long-term oncologic outcomes.Copyright © 2024 Elsevier Inc. All rights reserved.