Laparoscopic treatment of space occupying lesions in pancreatic body and tail: a report of 65 patients

Abstract

Objective To study the surgical treatment strategies, techniques and results of laparoscopic surgery for space occupying lesions in pancreatic body and tail. Methods To retrospectively analyze the clinical data of 65 patients with space occupying lesions in pancreatic body and tail. These patients were consecutively treated in Department of Minimally Invasive Surgery, the First Affiliated Hospital of Zhengzhou University from January 2010 to November 2017. Results All operations on the 65 patients were performed laparoscopically. The operations included laparoscopic distal pancreatectomy with splenectomy (n=22), spleen preserving laparoscopic distal pancreatectomy (n=43, with Kimura’s method, n=38; and Warshaw’s method, n=5). The mean size of the lesions was 5.5 cm (range 1.0~11.2 cm). The mean intraoperative blood loss was 120 ml (range 30~350 ml). The mean operation time was 230 min (range 160~310 min). Complications developed in 11 patients (16.9%). There were no tumour recurrence on follow-up which ranged from 1 to 81 months. Conclusions For patients with space occupying lesions in pancreatic body and tail, surgical strategies should be planned according to the site of the lesion and its relation to the blood vessels of the spleen. With good surgical techniques, laparoscopic treatment of lesions in pancreatic body and tail can be carried out safely, with a low complication rate and with an increased spleen preservation rate. Key words: Laparoscopes; Spleen; Distal pancreatectomy