title: Laparoscopic minor pancreatic resections (enucleations/atypical resections). A long-term appraisal of a supposed mini-invasive approach.
abstract: BACKGROUND
  A few retrospective, small, often multicentric studies show encouraging results of laparoscopic minor pancreatic surgery, but do not allow for an evaluation of feasibility and effectiveness.
  
  
  OBJECTIVE
  Evaluation of the results of laparoscopic minor pancreatic resections (LMPR), including atypical resections and enucleations.
  
  
  METHODS
  The outcome of all consecutive patients undergoing LMPR in a tertiary care university hospital specializing in the laparoscopic approach to solid organs (I.M.M., Paris - France) was retrospectively evaluated by the analysis of operating time, blood loss, conversion, morbidity, stay and late outcome.
  
  
  RESULTS
  Thirty-three patients underwent LMPR (29 enucleations and 4 atypical resections) for various diseases. The conversion rate was 21%, mean operating time 189 min, and mean blood loss 133 ml. Morbidity was 60%; 10 patients (30%) presented a pancreatic fistula. Pancreatic fistula was independent of type of resection, technique of pancreas section, management of enucleated surface and somatostatin administration. Median stay for enucleations was 18 days. Mean follow-up was 61 months.
  
  
  CONCLUSIONS
  Laparoscopic pancreatic enucleation is feasible and safe, with no mortality, no lengthening of operating time and a high success rate. Conversely, it does not imply a reduction in complications or hospital stay at the present state of the art.
authors.affiliation: Département de Pathologie Digestive, Institut Mutualiste Montsouris, Paris, France ; Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, Parma, Italia.
authors.forename: Renato
authors.initials: R
authors.lastname: Costi
authors.forename: Bruto
authors.initials: B
authors.lastname: Randone
authors.forename: Frédérick
authors.initials: F
authors.lastname: Mal
authors.forename: Silvia
authors.initials: S
authors.lastname: Basato
authors.forename: Hugues
authors.initials: H
authors.lastname: Levard
authors.forename: Brice
authors.initials: B
authors.lastname: Gayet
keywords: laparoscopy; morbidity; pancreas; pancreatic fistula; treatment outcome