P Senthilnathan, Anand Vijai, V P Nalankilli, G Srivatsan, Sandeep Sabnis, Dilip Gode, R Parthasarathi, S Rajapandian, P Praveen Raj, C Palanivelu. GEM Hospital & Research Centre
Background: Laparoscopic distal pancreatectomy gradually evolved as the standard approach for the management of lesions of distal body and tail of pancreas. Since its inception, this technique had many technical modifications. We present our experience of this procedure, its modifications and concurrent results over the past seventeen years.
Methods: This is a review of prospectively maintained database from single center from 1998 till 2015. Indications for laparoscopic distal pancreatectomy were lesions of distal body or tail of pancreas (benign looking or pre-malignant or malignant). All the clinico-pathological data, operative variables and postoperative morbidity including pancreatic fistula were analyzed.
Results: During the period, 82 patients underwent laparoscopic distal pancreatectomy for pancreatic lesions. The median age was 45yrs with female to male ratio of 2.5:1. The mean tumor size was 5.1+2.9 cm. The mean operating time was 205+48 min. Spleen preservation was possible in 14 patients. The mean post-operative hospital stay was 4.9+1.3days. Significant pancreatic fistula (grade B/C) was detected in 4 patients. Male sex and BMI >25 kg/m2 were found significantly associated with occurrence of pancreatic fistula on regression analysis. Seven patients were diagnosed of pancreatic ductal adenocarcinoma and two with mucinous adenocarcinoma. One patient was detected with recurrence, during follow-up.
Conclusion: A laparoscopic approach to distal pancreatectomy is an acceptable approach for benign, premalignant as well as malignant diseases of the pancreas. However, this procedure is technically demanding and should be performed only by surgeons with sufficient experience in both open pancreatic surgery and advanced laparoscopic gastrointestinal surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80854
Program Number: P454
Presentation Session: Poster (Non CME)
Presentation Type: Poster