title: Laparoscopic Distal Pancreatectomy with or without Preservation of the Spleen for Solid Pseudopapillary Neoplasm.
abstract: Solid pseudopapillary neoplasm (SPN) is a rare tumor of the pancreas. Laparoscopic distal pancreatectomy (DP) is a feasible and safe procedure, and successful spleen preservation rates are higher using a laparoscopic approach. We hypothesized that certain patients with SPN would be good candidates for laparoscopic surgery; however, few surgeons have reported laparoscopic DP for SPN. We discuss the preoperative assessment and surgical simulation for two SPN cases. A simulation was designed because we consider that a thorough preoperative understanding of the procedure based on three-dimensional image analysis is important for successful laparoscopic DP. We also discuss the details of the actual laparoscopic DP with or without splenic preservation that we performed for our two SPN cases. It is critical to use appropriate instruments at appropriate points in the procedure; surgical instruments are numerous and varied, and surgeons should maximize the use of each instrument. Finally, we discuss the key techniques and surgical pitfalls in laparoscopic DP with or without splenic preservation. We conclude that experience alone is inadequate for successful laparoscopic surgery.
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Tomohide
authors.initials: T
authors.lastname: Hori
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Masui
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yasuchika
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Seo
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Takaori
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mizumoto
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Iida
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto