{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:14:48Z","timestamp":1788480888075,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Neuroendocrinology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pancreatic neuroendocrine tumors (PanNETs) are increasingly detected, and the optimal extent of resection remains uncertain because perioperative burden and oncologic assessment may differ by procedure. Enucleation (EN) and central pancreatectomy (CP) are often grouped together as parenchyma\u2010sparing resections (PSRs) despite substantial differences in technical complexity, postoperative risk, and oncologic evaluation.We conducted a multicenter retrospective study of consecutive patients who underwent resection for pathologically confirmed PanNETs \u226420\u2009mm. Procedures were categorized as EN, CP, pancreatoduodenectomy (PD), total pancreatectomy (TP), or distal pancreatectomy (DP). Primary outcomes were clinically relevant postoperative pancreatic fistula (CR\u2010POPF) and major morbidity, defined as Clavien\u2010Dindo grade \u2265IIIa. A prespecified pairwise comparison focused on EN and CP, and pathologic assessment patterns were analyzed descriptively across procedures. Of 460 patients, 164 (35.7%) underwent EN, 40 (8.7%) CP, 84 (18.2%) PD\/TP, and 172 (37.4%) DP. CR\u2010POPF occurred in 115 patients (25.0%), major morbidity in 68 (14.8%), and 90\u2010day mortality in 4 (0.9%). Among PSRs, CP had higher major morbidity than EN (25.0% vs 10.4%,\n                    <jats:italic>p<\/jats:italic>\n                    =.020), higher CR\u2010POPF (50.0% vs. 24.4%,\n                    <jats:italic>p<\/jats:italic>\n                    =.003), and a longer median hospital stay (19.5 vs. 10.0\u2009days,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;.001). Lymph node (LN) assessment was less frequent after EN than CP (40.4% vs. 87.5%,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;.001). Among assessed cases, LN metastases were identified in 44\/320 patients (13.8%). EN and CP are not interchangeable as parenchyma\u2010sparing options for small PanNETs. Among patients selected for resection, procedure selection should consider tumor location, function, technical feasibility, and oncologic requirements rather than size alone.\n                  <\/jats:p>","DOI":"10.1111\/jne.70243","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T22:46:24Z","timestamp":1786488384000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Procedure\u2010specific morbidity and pathologic assessment after resection of small (\u226420\u2009mm) pancreatic neuroendocrine tumors"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-9978","authenticated-orcid":false,"given":"Aya","family":"Maekawa","sequence":"first","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2072-7114","authenticated-orcid":false,"given":"Giampaolo","family":"Perri","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Partelli","sequence":"additional","affiliation":[{"name":"Pancreatic and Transplantation Surgical Unit, IRCCS San Raffaele Hospital, Vita\u2010Salute University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6011-7663","authenticated-orcid":false,"given":"Charles","family":"de Ponthaud","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery Piti\u00e9\u2010Salp\u00e9tri\u00e8re Hospital, AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safi","family":"Dokmak","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery and Liver Transplantation Beaujon Hospital, AP\u2010HP Nord, Universit\u00e9 Paris Cit\u00e9, CRI\u2010INSERM UMR 1149  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"J\u00e4ger","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine and Health, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3880-2569","authenticated-orcid":false,"given":"Maria Lavinia","family":"Luzietti","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3365-7713","authenticated-orcid":false,"given":"Alessio","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3793-2982","authenticated-orcid":false,"given":"Valentina","family":"Andreasi","sequence":"additional","affiliation":[{"name":"Pancreatic and Transplantation Surgical Unit, IRCCS San Raffaele Hospital, Vita\u2010Salute University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3748-2255","authenticated-orcid":false,"given":"Anna","family":"Battistella","sequence":"additional","affiliation":[{"name":"Pancreatic and Transplantation Surgical Unit, IRCCS San Raffaele Hospital, Vita\u2010Salute University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengi Su","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine and Health, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4980-956X","authenticated-orcid":false,"given":"Andrea","family":"Sheel","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery Liverpool University Hospitals NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-1273","authenticated-orcid":false,"given":"Kunal","family":"Rajput","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Department of Surgery and Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2310-0245","authenticated-orcid":false,"given":"Umberto","family":"Cillo","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG) University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7436-5999","authenticated-orcid":false,"given":"Alain","family":"Sauvanet","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery and Liver Transplantation Beaujon Hospital, AP\u2010HP Nord, Universit\u00e9 Paris Cit\u00e9, CRI\u2010INSERM UMR 1149  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6029-5857","authenticated-orcid":false,"given":"Helmut","family":"Friess","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine and Health, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan D.","family":"Baron","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery Liverpool University Hospitals NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-7639","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Gaujoux","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery Piti\u00e9\u2010Salp\u00e9tri\u00e8re 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