Retroperitoneoscopic pancreatectomy: A totally new surgical approach for pancreas.

Guodong Zhao, MD, Rong Liu, PhD, Minggen Hu, MD

Chinese People’s Liberation Army (PLA) General Hospital

Objective The advantage of retroperitoneoscopy in urology has been widely acknowledged. Some animal experiments indicated that this approach is potentially feasible in humans, but the debate on the efficacy and safety of retroperitoneoscopic pancreatectomy continues. This study aimed to evaluate the feasibility of retroperitoneoscopic pancreatectomy in a prospective cohort of patients.

Methods Between February 2010 and August 2012, 16 patients with a suspected diagnosis of distal pancreatic lesions were selected to undergo retroperitoneoscopy. Approval was obtained from both the institutional review board approval. The exposition of pancreas under retroperitoneoscopy was done in two different anatomical pathways.

Results 11 patients with histologically-confirmed pancreatic diseases underwent enucleation (n = 6) or distal pancreatectomy with splenic preservation (n = 3). Operative times ranged from 30 – 100 min with a controllable blood loss of 10 – 100 ml. Two case of intraoperative retroperitoneal perforation and four cases of pancreatic fistula occurred. All 11 patients were discharged within 8 days postoperatively. The other 5 patients with non-pancreatic diseases underwent a retroperitoneoscopic resection with an excellent clinical outcome.

Conclusions This study presented the primary clinical experience of retroperitoneoscopic pancreatectomy. The results indicate that retroperitoneoscopy was feasible and effective for selected patients with lesions located in the distal pancreas with some potential advantages, like a natural and direct access, short operating time, insignificant blood loss, simple manipulations, minor complications and fast postoperative recovery. However, further study is needed to evaluate this new surgical approach.

Session: Poster Presentation

Program Number: P497

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