Total laparoscopic distal pancreatectomy for a benign appearing tumor: a case report.
BACKGROUND
Therapeutic laparoscopy of the pancreas is still described as experimental surgery by many surgeons. Many issues remain to be clarified in determining the future of this new method.


METHODS
The objective of the present study was to present a case of a patient who underwent totally laparoscopic distal pancreatectomy for a benign appearing tumor in the tail of the pancreas and to critically discuss the treatment of the pancreatic remnant and the need to perform splenectomy with or without ligation of the splenic vessels.


CONCLUSIONS
Laparoscopic distal pancreatectomy is usually performed en-bloc along with resection of the spleen, for technical reasons, making the operation short and easy. However, it should only be performed in centers with expertise in both pancreatic surgery and advanced laparoscopy. Furthermore, the use of linear stapler to cut the pancreas (4.5-mm staples) seems to prevent fistula formation and ischemia of the pancreatic stump.
Kosmidis
Christopher
C
Department of Surgery, Interbalkan European Medical Center, Asklipiou 10, 57 001 Pylaia, Thessaloniki, Greece. dr.ckosmidis@gmail.com
Efthimiadis
Christopher
C
Anthimidis
George
G
Grigoriou
Marios
M
Toulis
Evangelos
E
Levva
Sofia
S
Prousalidis
Ioannis
I
Fachantidis
Epaminondas
E