title: The detail of the en bloc technique and prognosis of spleen-preserving laparoscopic distal pancreatectomy for pancreatic cancer.
abstract: BACKGROUND
  Although laparoscopic spleen-preserving distal pancreatectomy surgery is more and more popular, the reports about the en bloc technique used for pancreatic cancer were still rare. The aim of our study was to illustrate the detail of the spleen-preserving en bloc technique as well as the short-term and long-term outcomes.
  
  
  METHODS
  The detail of the en bloc technique with pictures was described. The prognosis of the successive 23 cases that underwent the laparoscopic distal pancreatectomy (LDP) surgery was evaluated.
  
  
  RESULTS
  There were 17 cases that underwent spleen-preserving LDP while six cases underwent spleen-resecting LDP. The average surgery time was 203 ± 54 min, and the average blood loss volume was 208 ± 264 ml; one case transferred to open surgery because of severe adhesion. The complication rate was 47 % (n = 8) shortly after surgery. Pancreatic fistula rate was 41 % (n = 7). No lethal case occurred. The average diameter of the tumor was 32 ± 12 mm. The average number of the lymph nodes obtained was 19.8 ± 9.3. All the cutting edges were negative. Survival rates of the patient after 1, 3, and 5 years are 64.7, 52.9, and 41.2 %, respectively. These records showed no statistical significance compared with spleen-resecting LDP and open distal pancreatectomy (ODP) surgeries.
  
  
  CONCLUSIONS
  The en bloc spleen-preserving LDP can be performed by experienced surgeons. This surgery has good short-term and long-term outcomes.
authors.affiliation: Oncology Surgery Department, Peking University Ninth School of Clinical Medicine (Beijing Shijitan Hospital, Capital Medical University), 334room, Administrative Building, Beijing, China. sunzhipeng56084@163.com.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Oncology Surgery Department, Peking University Ninth School of Clinical Medicine (Beijing Shijitan Hospital, Capital Medical University), 334room, Administrative Building, Beijing, China. zyb519@hotmail.com.
authors.forename: Yubing
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Oncology Surgery Department, Peking University Ninth School of Clinical Medicine (Beijing Shijitan Hospital, Capital Medical University), 334room, Administrative Building, Beijing, China. zhangnw1@sohu.com.
authors.forename: Nengwei
authors.initials: N
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000401:mortality*; D008207:Lymphatic Metastasis; D008297:Male; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D010180:Pancreatectomy / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D013154:Spleen / Q000601:surgery*; D015996:Survival Rate