title: Toward a standard technique for laparoscopic distal pancreatectomy? Synthesis of the 2013 ACHBT Spring workshop.
abstract: Laparoscopic distal pancreatectomy is currently a commonly performed procedure. Twenty-five retrospective studies comparing laparotomy and laparoscopy have dealt with the feasibility of this approach for localized benign and malignant tumors. However, these studies report several different techniques. The aim of this review was to determine if a standardized procedure could be proposed. Based on the literature and the experience of surgeons in the French Association of Hepatobiliary Surgery and Liver Transplantation (ACBHT-Association française de chirurgie hépato-biliaire et de transplantation hépatique), we recommend primary control of the splenic artery, use of linear staplers for pancreatic transection, splenic vein control either at its end or its origin, and, depending on local conditions, preservation of the splenic vessels when splenic preservation is envisioned. Current data do not allow establishment of any definitive recommendations as to the ideal site of pancreatic transection, operative patient position, or the direction of dissection, which mainly depends on local practices. Control of the splenic vein remains the critical point of this procedure, and impacts the intra-operative strategy.
authors.affiliation: Service de chirurgie générale et digestive et de transplantation hépatique, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: K
authors.initials: K
authors.lastname: Mohkam
authors.affiliation: Hôpital Beaujon, 92110 Clichy, France.
authors.forename: O
authors.initials: O
authors.lastname: Farges
authors.affiliation: Hôpital Huriez, 59000 Lille, France.
authors.forename: F-R
authors.initials: FR
authors.lastname: Pruvot
authors.affiliation: Hôpital Rangueil, 31000 Toulouse, France.
authors.forename: F
authors.initials: F
authors.lastname: Muscari
authors.affiliation: Hôpital Nord, 80000 Amiens, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Régimbeau
authors.affiliation: Hôtel-Dieu, 44000 Nantes, France.
authors.forename: N
authors.initials: N
authors.lastname: Regenet
authors.affiliation: Hôpital Paul-Brousse, 94800 Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Sa Cunha
authors.affiliation: Hôpital Beaujon, 92110 Clichy, France.
authors.forename: S
authors.initials: S
authors.lastname: Dokmak
authors.affiliation: Service de chirurgie générale et digestive et de transplantation hépatique, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address: jean-yves.mabrut@chu-lyon.fr.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Mabrut
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010180:Pancreatectomy / Q000379:methods*; D013156:Splenectomy / Q000379:methods; D013157:Splenic Artery / Q000601:surgery; D013162:Splenic Vein / Q000601:surgery
keywords: Laparoscopy; Left pancreatectomy; Left pancreatosplenectomy; Preservation of splenic vessels; Splenic preservation