The Feasibility and Safety of Laparoscopic Distal Pancreatectomy for Pancreatic Tumor

Long Vo Duy, Ms, Bac Nguyen Hoang, Prof PhD, Tuan Le Quan Anh, Ms. University Medical Center, Hochiminh city, Vietnam


 Background: Distal pancreatectomy is performed for a range of benign and malignant lesions of the left pancreas. Laparoscopic distal pancreatectomy is increasingly performed for lesions of the body and tail of the pancreas. The aim of this study is to evaluate the technical procedures, the feasibility and the safety of laparoscopic distal pancreatic resections for solid and cystic tumors of the distal pancreas.
Methods: This was a prospective, case- series with a total of 18 patients affected by solid and cystic tumors were underwent laparoscopic distal pancreatectomy at University Medical Center, Hochiminh city, Vietnam between March 2007 and August 2011. Clinical characteristics as well as diagnostic preoperative assessment and intra- and postoperative data were prospectively recorded.
Results: There were 10 women and 8 men with a mean age of 50 years. All procedures were successfully performed laparoscopically. The median tumor size was 40 mm (range, 20-100 mm). The mean operative time was 156 ± 32 minutes. The estimated intraoperative blood loss was 90 ± 12 ml and no patient required blood transfusion. Spleen preservation was done in 4 patients (22.2%). There were no mortalities. The median length of hospital stay was 6 days. No patients developed in postoperative pancreatic fistula. The overall morbidity rate was 16.7% (3 patients) including fluid collections in 2 patients which were asymptomatic and resolved spontaneously and wound infections in 1 patient but no patient required reoperation. The final pathologic diagnoses consisted of primary adenocarcinoma (n = 5), and others benign lesions including serous cystadenoma (n = 5), solid pseudopapillary tumor (n=4) and mucinous cystadenoma (n = 4). All 5 patients of adenocarcinoma had negative resection margins. The median number of nodes in the specimens was 6 with none of them had positive metastasis. All the patients with adenocarcinoma are alive and free from disease at a median follow-up of 18 months (range, 4 – 38 months).
Conclusions: Laparoscopic distal pancreatectomy is feasible and safe. Solid and cystic tumors of the distal pancreas represent a good indication for laparoscopic resection whenever possible.

Session Number: Poster – Poster Presentations
Program Number: P221
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