Laparoscopic distal pancreatectomy: our experience in tertiary care center

Abstract

Introduction: With advances in minimal access surgery, laparoscopic DP with or without splenectomy is slowly gaining acceptance as an alternative to open surgery in selected cases. Methods and materials: A retrospective review of our data was carried out. From 2010-2016, we performed eight DP by the laparoscopic approach. A 5 port approach was used. The specimen was divided using endo-GIA stapler (purple/green cartridge). The decision of spleen preserving was made if the splenic vessels and the splenic hilum were free. The specimen was retrieved in endobag using Pfannenstiel incision. The perioperative parameters, morbidity, and follow-up results were analyzed. Results: From 2010–2016, eight patients underwent laparoscopic DP. All eight were females. Two patients underwent spleen preserving DP. None of the cases were converted to open surgery. The mean operative time was 4 hours (5–6 hours). The mean diameter of tumor was 4 cm (3–5 cm). Two patients developed post operative pancreatic fistula ISGPF grade 1–2 which was managed conservatively. The mean hospital stay was 7 days (6–8 days). The final diagnosis was serous cystadenoma in one patient, mucinous cystadenoma in four patients, NET in one patient and solid pseudopapillary tumor in two patients. The mean follow up period was 3 years (2–4 years) with no recurrence. Conclusion: Laparoscopic distal pancreatectomy is safe and technically feasible for selected patients with benign and low grade malignant pancreatic tumor with acceptable morbidity and clinical outcomes.