Laparoscopic Splenic-preservationdistal Pancreatectomy: With9cases Report

Objective: To explore the safety and advantages of laparoscopic distalpancreatectomy in the treatment of the tumor in the body and tail of the pancreas.Methods: The medical records of9consecutives patients who had a laparoscopicdistal pancreatectomy at Fujian Provincial Hospital from October2008toDecember2011(all of them preserved the spleen without conversion,8preservedthe spleen by Kimura method, another one preserved the spleen by Warshawmethod) and the literatures of domestic and foreign countries about laparoscopicdistal pancreatectomy were reviewed.Results: All of the patients successfully underwent laparoscopicspleen preserved pancreatectomy without converted, with an averageoperative time167.9min (120~200min) and a mean intraoperative blood loss of194.4ml (50~400ml), the mean postoperative length of stay is8.3days (5~13days).1patient had a grade B pancreatic fistula, which resolved conservatively.The most common postoperative diagnosis was solid pseudopapillary tumor ofpancreas in4patients, followed by pancreatic islet cell tumor in2patients,pancreatic pseudocysts in1patient, serous cystadenoma of pancreas in1patient,and pancreatic neuroendocrine carcinoma in1patient. Follow-up was availablein all the patients for4to40months, during the period, no diabetes andrecurrence was detected. The literatures of domestic and foreign countries aboutlaparoscopic distal pancreatectomy were reviewed and the safety andadvantages of laparoscopic distal pancreatectomy was also investigated, althoughlaparoscopic distal pancreatectomy would increase the cost in hospital.Conclusions: Laparoscopic distal pancreatectomy is safe and feasible in thetreatment of benign and low-grade malignant pancreatic diseases. As comparewith open distal pancreatectomy, laparoscopic distal pancreatectomy is moreminimally invasive, earlier recovery, shorter length of stay, et al. clinical results are also satisfactory, it is worth of promotion.