Igor Khatkov, MD, Roman Izrailov, MD, Magomet Baychorov, MD, Arthur Khisamov, Pavel Tytyunnik, MD, Alexey Andrianov. Moscow Clinical Scientific Center
Background: Laparoscopic distal pancreatectomy was firstly performed in 1994 by A. Cuschieri. Since that time it had become a gold standard for treatment of patient with lesions of distal parts of the pancreas.
Number of articles showed the advantages of laparoscopic approach over open procedure in terms of blood loss and hospital stay.
However technical complexity of procedure limits its’ use in some cases including large tumors, vessels involving.
Methods: Herein we describe the cases of technically demanding distal pancreatectomies.
Results: The first patient was 65 years old male with large pancreatic neuroendocrine tumor with spreading on spleen causing spleen infarction and splenic flexure of colon. Laparoscopic distal pancreatectomy with colon resection was performed. Time of operation was 260 min, blood loss was 200 ml. Postoperative course was uneventful and patient was discharged on POD 7.
The second case is laparoscopic distal pancreatectomy with segmental superior mesenteric vein/portal vein resection in patient with pancreas body adenocarcinoma with venous involvement. Patient was 49 years old male. Time of operation was 260 min, blood loss was 200 ml. Postoperative course was complicated by pancreatic fistula grade B, that was managed by drain placement. Hospital stay was 7 days.
The third patients was 61 years old female with pancreatic body adenocarcinoma with celiac axis and common hepatic artery involvement. Laparoscopic modified Appleby procedure was performed. Time of operation was 295 min. Blood loss was 200 ml. No complications were occurred postoperatively. Patient was discharged on POD 7.
Conclusions: laparoscopic approach in distal pancreatectomy can be safely applied in cases of large tumors invading neighbor organs or in case of vessels invasion.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88256
Program Number: V136
Presentation Session: Solid Organ Session
Presentation Type: Video