title: Laparoscopic spleen-preserving distal pancreatectomy for insulinoma: experience of a single center.
abstract: BACKGROUND
  Laparoscopic spleen-preserving distal pancreatectomy is gaining acceptance for the treatment of insulinomas of the pancreatic body and tail. The aim of this report is to evaluate the feasibility, safety and outcomes of this procedure in a retrospective series.
  
  
  METHODS
  From May 2004 to November 2013, 9 patients underwent laparoscopic spleen-preserving distal pancreatectomy for benign insulinomas in our department. Tumors were single and sporadic in eight patients, while the remaining patient had insulinomas in the setting of multiple endocrine neoplasia type 1. Tumors were located by preoperative imaging in all cases. Laparoscopic ultrasound was always performed to guide the surgical procedure.
  
  
  RESULTS
  All the operations were carried out laparoscopically with a mean operative time of 110 min (range 90-210 min) and a mean blood loss of 50 ml (range 30-120 ml). One patient (11.1%) died on the 22nd post-operative day for massive intra-abdominal bleeding associated with pancreatitis of the stump. Two patients (22.2%) developed pancreatic fistula that healed conservatively. Mean postoperative hospital stay was 7.1 days (range 5-18 days). All alive patients were free from recurrence after a mean follow-up of 45 months (range 11-72 months).
  
  
  CONCLUSIONS
  Laparoscopic spleen-preserving distal pancreatectomy is safe and feasible for the management of benign insulinomas. Definition of the tumor with preoperative imaging and laparoscopic ultrasound is essential to achieve high cure rate with minimal conversion.
authors.affiliation: Department of Laparoscopic and Robotic Surgery, "Azienda Ospedaliera dei Colli" - Monaldi Hospital, Via Leonardo Bianchi s.n.c., 80131 Naples, NA, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sciuto
authors.affiliation: Department of Laparoscopic and Robotic Surgery, "Azienda Ospedaliera dei Colli" - Monaldi Hospital, Via Leonardo Bianchi s.n.c., 80131 Naples, NA, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Abete
authors.affiliation: Department of Laparoscopic and Robotic Surgery, "Azienda Ospedaliera dei Colli" - Monaldi Hospital, Via Leonardo Bianchi s.n.c., 80131 Naples, NA, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Reggio
authors.affiliation: Department of Laparoscopic and Robotic Surgery, "Azienda Ospedaliera dei Colli" - Monaldi Hospital, Via Leonardo Bianchi s.n.c., 80131 Naples, NA, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Pirozzi
authors.affiliation: Department of Laparoscopic and Robotic Surgery, "Azienda Ospedaliera dei Colli" - Monaldi Hospital, Via Leonardo Bianchi s.n.c., 80131 Naples, NA, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Settembre
authors.affiliation: Department of Laparoscopic and Robotic Surgery, "Azienda Ospedaliera dei Colli" - Monaldi Hospital, Via Leonardo Bianchi s.n.c., 80131 Naples, NA, Italy. Electronic address: Francesco.corcione@ospedalideicolli.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Corcione
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013154:Spleen / Q000601:surgery*; D016896:Treatment Outcome
keywords: Insulinoma; Laparoscopic distal pancreatectomy; Laparoscopic ultrasound; Pancreatic benign tumors; Spleen-preserving