Laparoscopic left pancreatectomy: early results after 115 consecutive patients

Abstract

Introduction: Despite its proven feasibility and good results, the use of laparoscopy in left-sided pancreatic lesions is considered a challenging procedure, and therefore, its utilization is still low. In this paper, we aim to describe the early outcomes obtained after laparoscopic left pancreatectomies performed over 15 years.

Patients and methods: From 1997 until 2014, 115 consecutive patients underwent laparoscopic left pancreatectomy at CHU Bordeaux and Centre Hépato-Biliaire, which were prospectively recorded in a database. An analysis of this database was performed in order to evaluate preoperative, intraoperative and immediate postoperative outcomes.

Results: Laparoscopic left pancreatectomy with spleen conservation was performed in 64 patients (55.7 %). The median operative time was 220 min, and median blood loss was 200 ml. Conversion to open surgery was made in 15 (13 %) patients. Median postoperative hospital stay was 11 days, and overall postoperative complications occurred in 59 patients (51.3 %). Of these, 25.4 % were Clavien-Dindo grade III and above. The rate of clinical PF was 11.3 %. Three of the 64 patients with splenic preservation (4.7 %) developed a splenic infarction, and one of them needed splenectomy.

Conclusions: Results obtained after a long series of laparoscopic left pancreatectomy confirm its favorable outcomes and its association with a low postoperative morbidity rate.

Keywords: Distal pancreatectomy; Laparoscopic pancreatectomy; Laparoscopy; Pancreas; Pancreatectomy; Pancreatic surgery.