Resultados del abordaje laparoscópico en la pancreatectomía izquierda

Abstract

IntroductionLaparoscopic left-sided pancreatectomy (LLP) is an accepted technique for the treatment of benign and pre-malignant lesions of the left side of the pancreas, but there is still controversy on its use for malignant ones. ObjectiveTo evaluate our results in LLP as a routine technique for primary lesions of the left pancreas. Patients and methodsWe performed LLP in 15 patients for primary lesions of the pancreas from November 2007 to November 2011. An intra-abdominal drainage was left in all cases, and the recommendations of the International Study Group for Pancreatic Fistula were followed. ResultsThe mean age of the patients was 64±13 years. Six radical spleno-pancreatectomies, 3 corporo-caudal with preservation of the spleen, and 6 pure distal (4 with preservation of the spleen). There was one conversion. The mean surgical time was 230±69minutes. The mean post-operative stay was 8.1±7.6 days. At 90 days, complications were detected in 4 patients; 3 grade ii and one grade v according to the modified classification of Clavien. There was one grade B pancreatic fistula. The diagnosis was a malignant neoplasm in 53% of cases. The number of resected lymph nodes in the cases where a radical resection was planned due to cancer was 21.7±11.5, there being negative margins in all cases. ConclusionsLLP may be considered as a suitable technique for the treatment of primary pancreatic lesions, including malignant ones, provided that it is performed by groups with experience in pancreatic surgery and highly trained in laparoscopic surgery.