Sang Hyun Shin, Song Cheol Kim, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee. Asan Medical Center, University of Ulsan College of Medicine
Background: Laparoscopic distal panreatectomy (LDP) has been replacing the open procedure for benign or malignant diseases of the pancreas. However, it is often difficult to apply LDP for pancreatic ductal adenocarcinoma (PDAC) because its aggressive invasion to adjacent organs or major vessels.
Objectives: The objective of this study was to report our experiences for laparoscopic extended pancreatectomy with en-bloc resection of adjacent organs or major vessels for left-sided PDAC.
Methods: We reviewed data for all consecutive patients undergoing LDP for left-sided PDAC at Asan Medical Center (Seoul, South Korea) between April 2006 and December 2016. The patients who underwent laparoscopic extended panreatectomy with en-bloc resection of adjacent organs or major vessels were included in analyses.
Results: Of total 257 patients, 21 underwent laparoscopic extended pancreatectomy. There were 14 male and 7 female patients with a median age of 64.1 years. Resected adjacent organs or vessels were as following: stomach in 6, duodenum in 1, colon in 4, kidney in 2, superior mesenteric vein in 4, and celiac axis in 4. Median operative duration was 280 minutes, and median length of hospital stay was 9 days. Pathological reports revealed the following: a median tumor size of 3.5 cm, the tumor differentiation (well differentiated in 2, moderately differentiated in 17, and poorly differentiated in 2), T stages (T1 in 1, T3 in 18, and T4 in 2), and N stages (N0 in 10 and N1 in 11). R0 resection was achieved in 6 patients, and most R1 resection were tangential retroperitoneal margins. Postoperatively, clinically relevant postoperative pancreatic fistula was occured in 2 patients, and there was no 90-day mortality. Median overall survival was 19.6 months and 1 year survival rate was 71.1%.
Conclusions: Although laparoscopic surgery has limitations in treating extensive diseases, some selected patients can be applicable for laparoscopic extended pancreatectomy with acceptable complication and survival rates.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86650
Program Number: P530
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster