title: Laparoscopic central pancreatectomy for benign or low-grade malignant lesions in the pancreatic neck and proximal body.
abstract: BACKGROUND
  Laparoscopic central pancreatectomy (LCP) is a parenchyma-sparing minimally invasive surgical technique for removal of benign or low-grade malignant lesions from the neck and proximal body of the pancreas. The aim of this study was to compare the short- and long-term clinical outcomes of LCP with those of other pancreatectomies.
  
  
  METHODS
  During the study period, January 2007 to December 2010 (median follow-up 40.6 months), 287 pancreatectomies were performed for lesions in the neck and proximal body of the pancreas. To compare the clinical outcomes of LCP and other pancreatectomies, 26 cases of LCP, 14 cases of open central pancreatectomy (OCP), and 96 cases of extended laparoscopic distal pancreatectomy (E-LDP) were selected.
  
  
  RESULTS
  Tumor sizes in the LCP (2.2 cm) and OCP (2.9 cm) groups were smaller than in the E-LDP (4.0 cm) group. Mean operation time in the LCP group (350.2 min) was longer than in the OCP (270.3 min) and E-LDP groups (210.6 min). There were more surgical complications in the LCP (38.5 %) and OCP groups (50 %) than in the E-LDP group (14.6 %). Mean duration of postoperative hospital stay was 13.8 days for the LCP group, which was significantly shorter than for the OCP group (22.4 days). New-onset diabetes was less frequent after LCP than after E-LDP (11.5 vs. 30.8 %).
  
  
  CONCLUSIONS
  In selected patients with small and benign tumors in the pancreatic neck and proximal body LCP leads to increased postoperative morbidity but earlier postoperative recovery than OCP, and excellent postoperative pancreatic function (compared with E-LDP). LCP should, therefore, be considered a valid therapeutic option for selected patients.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Ulsan University College of Medicine and Asan Medical Center, 86 Asan Byeongwon-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Ki Byung
authors.initials: KB
authors.lastname: Song
authors.forename: Song Cheol
authors.initials: SC
authors.lastname: Kim
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Park
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Hwang
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Lee
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Eun Sung
authors.initials: ES
authors.lastname: Jun
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Shin
authors.forename: Hyoung Eun
authors.initials: HE
authors.lastname: Kim
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome