Laparoscopic distal pancreatectomy for solid and cystic pancreatic neoplasms: outpatient postoperative management.
BACKGROUND
Laparoscopic distal pancreatectomy is a challenging procedure that has been reported in the last decade. The aim of this study is to describe our experience with laparoscopic distal pancreatectomy and an outpatient postoperative management after an early hospital discharge.


METHODS
Retrospective study of 11 laparoscopic distal pancreatectomies carried out at our institution between November 2005 and June 2007 for cystic and solid pancreatic neoplasms. Mean age was 55.5 years and 10 patients were females. A splenopancreatectomy was carried out in 9 cases, and a spleen-preserving resection was carried out in 2 cases.


RESULTS
Mean blood loss was 73.6 mL and mean operative time was 238.3 minutes. Patients were able to tolerate regular diet after a mean of 1.2 days and were discharged with a drain after a mean of 2.3 days. Two patients developed a mild pancreatic fistula that resolved with conservative management. One patient developed a pancreatic pseudocyst that was followed up with an MRI.


CONCLUSIONS
Laparoscopic distal pancreatectomy is feasible with a fast postoperative recovery. We recommend close follow-up of the patient in the outpatient clinic and maintaining the intraabdominal drain until a pancreatic fistula can be ruled out based on biochemical analysis of the fluid.
Elola-Olaso
Almudena Moreno
AM
Department of Minimally Invasive Surgery, General Surgery, University of Kentucky Medical Center, Lexington, KY 40515, USA. morenoalmudena@hotmail.com
Allen
Amber
A
Gagliardi
Raymond J
RJ
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010180:Pancreatectomy / Q000379:methods*; D010185:Pancreatic Fistula / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011184:Postoperative Period; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods