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Side-Branch Intraductal Papillary Mucinous Neoplasms of the Pancreas: Enucleation or Standard Pancreatic Resection: Systematic Review with Meta-Analysis

Wajih Dougaz, Ibtissem Bouasker, Imen Samaali, Mehdi Khalfallah, Akrem Sebai, Ramzi Nouira, Chedli Dziri

Background Side-branch intraductal papillary mucinous neoplasms of the pancreas have a low malignant potential, usually treated by pancreatic resection. Less invasive surgery, including enucleation, has been introduced for management of benign intraductal papillary mucinous neoplasms to decrease postoperative mortality and morbidity. This study aimed to compare enucleation to pancreatic resection for side-branch intraductal papillary mucinous neoplasms of the pancreas regarding risk of mortality and morbidity. Methods An extensive electronic search of the relevant literature was performed using the following databases: Medline, the Cochrane Library, Scopus, Embase and the Web of Science. Results Nineteen studies were retrieved. Only Four studies met eligible criteria. There were one prospective non-randomized study and three retrospective comparative studies. We performed a meta-analysis using Review manager 5.1. Conclusion This study showed that enucleation for side-branch intraductal papillary mucinous neoplasms provides more recurrence and post-operative pancreatic fistula than pancreatic resection without reaching the level of significance. On the other hand, enucleation provides less mortality, overall morbidity, and reoperation rates than pancreatic resection without reaching the level of significance for all comparisons.