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Pancreatic Neuroendocrine Tumor (NET) Enucleation Surgery

Parenchyma-sparing surgical excision of small pancreatic neuroendocrine tumors.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Pancreatic Neuroendocrine Tumor (NET) Enucleation Surgery?

Pancreatic neuroendocrine tumor (PNET) enucleation is a parenchyma-sparing operation in which a discrete, peripheral, and small tumor is shelled out of the pancreas without removing surrounding tissue. It is preferred for low-grade (G1, well-differentiated), insulinoma-type and incidentally detected, asymptomatic non-functioning PNETs less than 2 cm in size.

Patient selection involves multiphasic CT/MRI, endoscopic ultrasound (EUS), and 68Ga-DOTATATE PET-CT to assess size, location, distance from the main pancreatic duct (≥3 mm) and lymph node involvement. Open, laparoscopic, and robotic approaches are all accepted; intraoperative ultrasound is essential for localization and ductal mapping.

Compared to formal resections, enucleation preserves endocrine and exocrine function but carries a higher risk of postoperative pancreatic fistula (POPF). Long-term oncologic outcomes are excellent in well-selected G1 lesions; tumors with high grade, deep ductal involvement, or suspicious lymph nodes require formal resection.

Symptoms

Insulinoma symptoms (hypoglycemia)
Zollinger-Ellison features in gastrinoma
Flushing and diarrhea in functioning NETs
Often incidental imaging finding
Rarely abdominal pain or jaundice
Symptoms of MEN-1 syndrome
Mass effect in larger lesions

Risk Factors

Tumor size <2 cm
Peripheral or superficial location
Distance from main duct ≥3 mm
Well-differentiated G1 tumor
Insulinoma or asymptomatic NF-PNET
Single lesion without nodal disease
Suitable patient comorbidity profile

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent hypoglycemic episodes
  • Newly detected pancreatic mass
  • Family history of MEN-1
  • Persistent abdominal pain or weight loss
  • Postoperative high-output pancreatic fistula

Treatment Methods

01
Preoperative cross-sectional imaging and EUS
02
68Ga-DOTATATE PET-CT staging
03
Open, laparoscopic or robotic enucleation
04
Intraoperative ultrasound guidance
05
Drain placement and POPF management
06
Multidisciplinary follow-up with chromogranin A

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.