Yujo Kawashita, MD, Takashi Ueda, MD, Naonori Hazeyama, MD, Nobuhiro Shin, MD. Department of Endoscopic Surgery, Fukuoka Seisyukai Hospital
BACKGROUND: Minimally invasive surgery has become increasingly accepted as a technique for benign or low grade pancreatic tumors. It is generally pointed out that spleen salvage can eliminate the risk of overwhelming infections and maintain immunological functions.
Here we report our recent experiences of laparoscopic spleen-preserving distal pancreatectomy.
METHOD: A total of 7 patients underwent this procedure. After inserting a camera port, three working trocars were positioned. The body and tail of the pancreas were exposed by opening the lesser sac. The gastrocolonic, gastrosplenic, and splenocolonic ligaments were divided with ultrasonic scalpel and, followed by resection of the short gastric vessels with vessel sealing system. After exposure of the pancreas, the splenic artery was carefully mobilized, and the dissection between the pancreas and splenic vessel was continued. Following the creation of a posterior window, the body of the pancreas was transected with 60mm Endo-GIA. The distal part of the pancreas was further mobilized and completely dissected while preserving the spleen and its vessels.
RESULTS: Laparoscopic spleen-preserving pancreatectomies were successfully completed in all patients without conversion to open surgery. Reduced port surgery was performed in three cases with excellent cosmetic satisfactions. On average, operative time was 225min. The mean blood loss was 128ml and the mean postoperative hospital stay was 15days. Only one patient developed grade1 pancreatic fistula. Pathologically, there were 4 neuroendocrine tumors and 3 cystic tumors.
CONCLUSION: Laparoscopic spleen-preserving distal pancreatectomy is feasible and may be preferable to maximize the advantages of a minimally invasive approach in selected patients with pancreatic tumors.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80807
Program Number: P439
Presentation Session: Poster (Non CME)
Presentation Type: Poster