Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome.
BACKGROUND
Laparoscopic resection is not an established treatment for tumors of the pancreas. We report our preliminary experience with this innovative approach to pancreatic disease.


METHODS
Thirty two patients with pancreatic disease were included in the study on an intention-to-treat basis. The preoperative indications for surgery were as follows: neuroendocrine tumors ( n=13), unspecified tumors ( n=11), cysts ( n=2), idiopathic thrombocytopenic purpura with ectopic spleen ( n=2), annular pancreas ( n=1), trauma ( n=1), aneurysm of the splenic artery ( n=1), and adenocarcinoma ( n=1).


RESULTS
Enucleations ( n=7) and distal pancreatectomy with ( n=12) and without splenectomy ( n=5) were performed. Three patients underwent laparoscopic exploration only. Four procedures (13%) were converted to an open technique. One resection was converted to a hand-assisted procedure. The mortality rate for patients undergoing laparoscopic resection was 8.3% (two of 24). Complications occurred after resection in nine of 24 procedures (38%). The median hospital stay was 5.5 days (range, 2-22). Postoperatively, opioid medication was given for a median of 2 days (range, 0-13).


CONCLUSIONS
Resection of the pancreas can be performed safely via the laparoscopic approach with all the potential benefits to the patients of minimally invasive surgery.
Edwin
B
B
Interventional Center and Surgical Department, Rikshospitalet, Oslo, Norway.
Mala
T
T
Mathisen
Ø
Ø
Gladhaug
I
I
Buanes
T
T
Lunde
O C
OC
Søreide
O
O
Bergan
A
A
Fosse
E
E
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003537:Cystadenoma / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000601:surgery; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010179:Pancreas / Q000002:abnormalities / Q000293:injuries; D010180:Pancreatectomy / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D010181:Pancreatic Cyst / Q000601:surgery; D010182:Pancreatic Diseases / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013154:Spleen / Q000002:abnormalities; D013156:Splenectomy / Q000379:methods; D016896:Treatment Outcome