Laparoscopic distal pancreatectomy: a retrospective review of 14 cases.
Although the role of minimally invasive techniques in pancreatic surgery remains controversial, resection of the left pancreas for benign or endocrine lesions has been universally adopted as a routine technique over the last few years. This study was undertaken to assess feasibility and safety of minimal access resections of distal pancreas in benign, endocrine, and malignant diseases. Operative time, conversion rate, adequacy of dissection, respect for oncologic principles, morbidity rate, and short-term outcomes were analyzed. From the years 2002 to 2007, 14 patients affected by pancreatic neoplasm of body/tail region were approached by minimally invasive technique. Nine patients were affected by malignant neoplasms and distal splenopancreatectomy was successfully achieved by laparoscopy in 6. Five patients were affected by endocrine neoplasms; distal pancreatectomy with preservation of spleen and splenic vessels was achieved laparoscopically in 3, whereas 2 needed conversion to laparotomy. Four patients developed pancreatic leak after transection by linear cutting stapler plus oversewing, whereas no leak was observed within 30 days from surgery after transection by linear stapler with Seamguard reinforcement of the staple line (P<0.05 with Fisher exact test).
Department of General and Videolaparoscopic Surgery, Niguarda Hospital, Milan, Italy.
Raffaele
R
Pugliese
Dario
D
Maggioni
Fabio
F
Sansonna
Ildo
I
Scandroglio
Antonello
A
Forgione
Marco
M
Boniardi
Andrea
A
Costanzi
Davide
D
Citterio
Giovanni Carlo
GC
Ferrari
Stefano Di
SD
Lernia
Carmelo
C
Magistro
D000293:Adolescent; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011300:Preoperative Care; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome