Laparoscopic resection of the pancreatic tail with splenic preservation.
OBJECTIVE
Evaluation of feasibility and efficacy of left resection of the pancreas with preservation of the splenic vessels and spleen as a laparoscopic procedure.


BACKGROUND
Laparoscopic technique is used less often on the pancreas than on other organs. The most common indications are enucleation of endocrine-active tumors and distal resections for benign primary pancreatic lesions. An important premise of these operations is atraumatic removal of as little of the pancreas as possible and the preservation of the spleen and its main vessels.


METHODS
Five patients aged 16 to 56 years, all female, underwent laparoscopic left resection of the pancreas with preservation of the splenic vessels and the spleen. There were 4 cases of benign epithelial tumors of the pancreas and 1 case of a left-sided adrenal cyst, which pre- and intraoperatively gave the impression of a pancreatic cystadenoma.


RESULTS
In all 5 cases, the laparoscopic procedure was completed with preservation of the splenic vessels and the spleen itself. No patient required blood transfusion, and there was only 1 postoperative fluid collection at the site of the tumor resection, which was drained percutaneously on the fourth postoperative day.


CONCLUSIONS
Distal pancreas resection can be performed as a laparoscopic procedure, with the usual advantages that this techniques has for the patient. Optimal closure of the cut edge of the pancreas and the preservation of the spleen and its main vessels are the most important aspects of this operation.
Uranues
Selman
S
Department of Surgery, Medical University of Graz, Austria. Selman.uranues@meduni-graz.at
Alimoglu
Orhan
O
Todoric
Boban
B
Toprak
Necati
N
Auer
Thomas
T
Rondon
Luisangel
L
Sauseng
Gerhard
G
Pfeifer
Johann
J
D000293:Adolescent; D000328:Adult; D018291:Cystadenoma, Mucinous / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013154:Spleen / Q000098:blood supply / Q000601:surgery*; D013157:Splenic Artery / Q000601:surgery; D016896:Treatment Outcome