Enucleation offers a parenchyma-sparing surgical alternative for benign and low-grade pancreatic head tumors, with superior long-term quality of life compared to pancreatoduodenectomy.
Although enucleation results in higher rates of clinically relevant postoperative pancreatic fistula (CR-POPF), it is associated with fewer major complications, reduced delayed gastric emptying, and shorter hospitalization.
Patients undergoing enucleation experience lower incidence of new-onset diabetes and higher rates of return to work, particularly notable for tumors ≤2.5 cm in size.
Evidence supports enucleation as a technically feasible and oncologically acceptable approach for selected intraductal papillary mucinous neoplasms (IPMNs) and other low-risk pancreatic tumors in the head or uncinate process.
