title: Pure laparoscopic distal pancreatectomy with en bloc celiac axis resection.
abstract: BACKGROUND
  Recent technological developments and improved endoscopic procedures have greatly enlarged the applications of laparoscopic pancreatic resection.
  
  
  METHODS
  A 77-year-old female with invasive ductal cancer of the pancreatic body touching the common hepatic and splenic arteries underwent a pure laparoscopic distal pancreatectomy with en bloc celiac axis resection (DP-CAR). The celiac axis, the celiac plexus and ganglions, the left gastric artery, the Gerota fascia, the left adrenal gland, and the retroperitoneal fat tissues above the left renal vein were removed en bloc.
  
  
  RESULTS
  The procedure took 245 minutes and there was minimal blood loss. The postoperative course was uneventful and the patient was discharged on the seventh postoperative day. The surgical margins were histologically clear (R0 resection).
  
  
  CONCLUSIONS
  Pure laparoscopic DP-CAR is minimally invasive, safe and feasible, and can achieve R0 resection in selected patients with pancreatic invasive ductal adenocarcinoma.
authors: Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, Chiba, Japan. acho@chiba-cc.jp
authors: Akihiro
authors: A
authors: Cho
authors: Hiroshi
authors: H
authors: Yamamoto
authors: Osamu
authors: O
authors: Kainuma
authors: Takumi
authors: T
authors: Ota
authors: SeongJin
authors: S
authors: Park
authors: Atsushi
authors: A
authors: Ikeda
authors: Hiroaki
authors: H
authors: Souda
authors: Yoshihiro
authors: Y
authors: Nabeya
authors: Nobuhiro
authors: N
authors: Takiguchi
authors: Matsuo
authors: M
authors: Nagata
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D002447:Celiac Plexus / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*