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. 2009:2009:846340.
doi: 10.1155/2009/846340. Epub 2009 Dec 16.

Laparoscopic distal pancreatectomy with splenic conservation: an operation without increased morbidity

Peter Nau  1 , W Scott Melvin, Vimal K Narula, P Mark Bloomston, E Christopher Ellison, Peter Muscarella
Affiliations

Laparoscopic distal pancreatectomy with splenic conservation: an operation without increased morbidity

Peter Nau et al. Gastroenterol Res Pract. 2009.

Abstract

Objectives: The advent of minimally invasive techniques was marked by a paradigm shift towards the use of laparoscopy for benign distal pancreatic masses. Herein we describe one center's experience with laparoscopic distal pancreatectomy.

Methods: A retrospective chart review was performed for all distal pancreatectomies completed laparoscopically from 1999 to 2009. Outcomes from those cases completed with a concurrent splenectomy were compared to the spleen-preserving procedures.

Results: Twenty-four patients underwent laparoscopic distal pancreatectomy. Seven had spleen-conserving operations. There was no difference in the mean estimated blood loss (316 versus 285 mL, P = .5) or operative time (179 versus 170 minutes, P = .9). The mean tumor size was not significantly different (3.1 versus 2.2 cm, P = .9). There was no difference in the average hospital stay (7.1 versus 7.0 days, P = .7). Complications in the spleen-preserving group included one iatrogenic colon injury, two pancreatic fistulas, and two cases of iatrogenic diabetes. In the splenectomy group, two developed respiratory failure, three acquired iatrogenic diabetes, and two suffered pancreatic fistulas (71% versus 41%, P = .4).

Conclusions: The laparoscopic distal pancreatectomy is a safe operation with a low morbidity. Splenic conservation does not significantly increase the morbidity of the procedure.

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Figures

Figure 1
Figure 1
Identification and isolation of splenic vein at the dorsal aspect of the pancreas.
Figure 2
Figure 2
Transection of the pancreas with a linear stapling device using a bioabsorbable staple line reinforcement system.
Figure 3
Figure 3
Dissection of the pancreas off the splenic vessels for spleen preservation.
See this image and copyright information in PMC

References

    1. Dubois F, Icard P, Berthelot G, Levard H. Coelioscopic cholecystectomy. Preliminary report of 36 cases. Annals of Surgery. 1990;211(1):60–62. - PMC - PubMed
    1. Dulucq JL, Wintringer P, Stabilini C, Feryn T, Perissat J, Mahajna A. Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution. Surgical Endoscopy. 2005;19(8):1028–1034. - PubMed
    1. Edwin B, Mala T, Mathisen Ø, et al. Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surgical Endoscopy. 2004;18(3):407–411. - PubMed
    1. Khanna A, Koniaris LG, Nakeeb A, Schoeniger LO. Laparoscopic spleen-preserving distal pancreatectomy. Journal of Gastrointestinal Surgery. 2005;9(5):733–738. - PubMed
    1. Mabrut JY, et al. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005;137(6):597–605. - PubMed

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