Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors.
BACKGROUND
Laparoscopic distal pancreatectomy combined with spleen salvage by preservation of the splenic vessels has been described in selected patients with islet cell tumors.


METHODS
Laparoscopic resection of the left side of the pancreas with spleen preservation on the vasa brevia was attempted in six consecutive patients.


RESULTS
Four distal pancreatectomies with spleen preservation were completed laparoscopically. There were two conversions to laparotomy. The median operating time was 300 min (range, 240-360). There was no mortality, but two patients developed a pancreatic fistula. The median postoperative hospital stay was 34.5 days (range, 5-60). All the patients remain well at a median follow-up of 30 months (range, 22-41).


CONCLUSIONS
Minimally invasive surgery for distal pancreatic tumors is feasible and appropriate for most benign tumors. The spleen can be safely preserved laparoscopically on its blood supply from the short gastric vessels. The operative technique and especially the closure of the pancreatic stump need further study.
Vezakis
A
A
Leeds Institute for Minimally Invasive Surgery, and the Centre for Digestive Diseases, the General Infirmary at Leeds Great Gorge Street, Leeds, England LS1 3EX.
Davides
D
D
Larvin
M
M
McMahon
M J
MJ
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003537:Cystadenoma / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000473:pathology / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D013154:Spleen / Q000033:anatomy & histology / Q000601:surgery*; D013157:Splenic Artery / Q000033:anatomy & histology; D013162:Splenic Vein / Q000033:anatomy & histology; D016896:Treatment Outcome; D006623:von Hippel-Lindau Disease / Q000473:pathology / Q000601:surgery