Postoperative Outcomes of the Malignancy After Laparoscopic Distal Pancreatectomy

Ho-Seong Han, MD PhD, Yoo-Seok Yoon, MD PhD, Jai Young Cho, MD PhD, Keun Soo Ahn, MD, Ji Hoon Kim, MD. Seoul National University Bundang Hospital, Department of Surgery, Seoul National University College of Medicine, Korea

Purpose:
Laparoscopic distal pancreatectomy is a reliable and safe operation for selected patients with benign and low grade malignant lesions in the body and tail of the pancreas; however, its application for malignant lesions of the pancreas is rare. The aim of this study is to analyze and evaluate our experiences with laparoscopic surgery for malignant lesions of the pancreas.

Methods :
Laparoscopic distal pancreatectomy was performed for 87 patients from January 2005 to June 2010. Among them 9 cases were diagnosed as malignancy in postoperative pathologic reports.
Retrospective analysis was done on the clinical outcomes of the 9 patients.

Results:
There were 3 men and 6 women with a mean age of 59.5 years. The postoperative diagnosis were 4 Intraductal papillary mucinous carcinoma, 2 ductal adenocarcinoma, 1 mucinous cyst adenocarcinoma, 1 neuroendocrine carcinoma and 1 pancreas metastasis from renal cell carcinoma. Median operating time was 231min. Median estimated blood loss was 262(200–500)ml . There were no open conversion. 4 (44%) patients experienced complications ( 2 intraabdominal fluid collection, 1 spleen infarction , 1 enterocutaneous fistula). Median postoperative hospital stay was 11.6 (9–18) days. All the patients were considered to to have curative resection(R0). postoperatively. During median follow up period of 30 months(3-58). There were recurrence disease in 3 patients. One patient had liver metastasis, which was considered missed lesion at preoperatively which was considered as hemangioma at that time. Another two patients have liver metastasis and celiac lymph node metastasis., A patient who has liver metastasis were treated with RFA and he is still alive 60 months postoperatively. Remaining patient who has celiac lymph node metastasis was alive 9 months postoperatively.

Conclusion:
The outcomes after laparoscopic distal pancreatectomy for malignant pancreatic disease are acceptable.


Session: Poster
Program Number: P381
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