Ultrasound study as the primary method of intraoperative topical diagnosis in pancreatic neuroendocrine tumor surgery

Aim. To demonstrate the capabilities of intraoperative topical diagnosis of pancreatic neuroendocrine tumors using ultrasound.

Materials and methods. An analysis of surgical treatment in 436 patients with pancreatic neuroendocrine tumors was conducted. In 82 cases (control group), intraoperative exploration was performed through visual inspection and palpation. In the remaining 354 surgeries (main group), intraoperative ultrasound was additionally used following pancreatic mobilization, along with visual inspection and palpation.

Results. In the control group, the tumor could not be detected intraoperatively in 15% of cases. In the main group, the sensitivity of visual and palpatory assessment was 81%, while the sensitivity of intraoperative ultrasound was 98.8%during laparotomy and 95% during laparoscopic procedures. An enucleation technique for non-palpable pancreatic neuroendocrine tumors under intraoperative ultrasound guidance was developed.

Conclusion. Surgical interventions for pancreatic neuroendocrine tumors should be performed with intraoperative ultrasound. This not only allows for the detection of all tumors in the vast majority of cases but also enables the assessment of their anatomical relationship with ductal structures and vessels, which sometimes leads to timely adjustments in surgical strategy.

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