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Background: In the majority of cases enucleation represents definitive treatment for neuroendocrine pancreatic tumors (NEPT). However, enucleation is not a simple procedure, whether performed open or laparoscopically. It offers clear advantages to patients but pancreas related complications may occur. When NEPT arise in the head-neck of the pancreas can represent a surgical challenge.Aim: To define the complication rate and incidence of pancreatic fistula (PF) according to ISGPF in patients undergoing enucleation for NEPT.Material and Method: Between April 1998 and September 2009 52 patients underwent laparoscopic surgery for NEPT, 25 sporadic insulinoma and 27 non-functioning tumors. NEPT were localized in the pancreatic head in 6 patients, in the pancreatic neck in 9 patients, in the body in 28 patients and in the tail of the pancreas in 9 patients. We reviewed the operative results and postoperative courses in these patients. Intraoperative ultrasonography was used in all cases.Results: Mean diameter of sporadic insulinoma was 1-4 cm (range 0.6-20 mm) and of non functioning tumors was 3 cm (range 2.5-3.2 cm). 18 patients (76%) with sporadic insulinoma and 12 patients (44%) of non-functioning tumors underwent successful laparoscopic enucleation. Conversion rate to an open procedure was 6.6%.Overall PF after LapEn was observed in 12 patients (40%), however 50% was biochemical PF (grade A). The frequency of PF was significantly higher (P<0.01) after LapEn from the head (100%) comparing with from the neck (50%) and from the body of the pancreas (29%). ISGPF grade B and C was also higher after LapEn from the head-neck of the pancreas (41.6%) comparing with the body of the pancreas (8%). No patient required reoperation.Conclusion: This study confirmed the technical feasibility and acceptable morbidity associated with LapEn for NEPT. There was no operative mortality. Sixty percent of the patients who had LapEn had no complications. A major concern with LapEn from the head-neck of the pancreas is the possibility of PF however can often be managed with prolonged drainage without bowel rest.