Retrospective Study
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World J Gastroenterol. Oct 14, 2014; 20(38): 13966-13972
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13966
Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: A retrospective study
Jia-Fei Yan, Xiao-Wu Xu, Wei-Wei Jin, Chao-Jie Huang, Ke Chen, Ren-Chao Zhang, Ajoodhea Harsha, Yi-Ping Mou
Jia-Fei Yan, Xiao-Wu Xu, Wei-Wei Jin, Chao-Jie Huang, Ke Chen, Ren-Chao Zhang, Ajoodhea Harsha, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, Institute of Micro-invasive Surgery, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Author contributions: Mou YP designed the study; Yan JF and Xu XW wrote the manuscript; Jin WW and Huang CJ collected and analyzed the data; Yan JF and Chen K contributed to the interpretation of the data and revision of the paper; Chen K and Harsha A reviewed the manuscript for intellectual content; all authors have approved the version to be published.
Supported by Grants from Department of Health of Zhejiang Province, China, No. 2011ZHB003 and No. 2013RCB010
Correspondence to: Yi-Ping Mou, MD, PhD, Professor, Department of General Surgery, Sir Run Run Shaw Hospital, Institute of Micro-invasive Surgery, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. mouyiping2002@163.com
Telephone: +86-571-86006445 Fax: +86-571-86044817
Received: March 30, 2014
Revised: June 7, 2014
Accepted: June 25, 2014
Published online: October 14, 2014
Processing time: 199 Days and 2.6 Hours
Abstract

AIM: To describe the clinical characteristics, technical procedures, and outcomes of patients undergoing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for benign and malignant pancreatic neoplasms.

METHODS: The clinical data of 38 patients who underwent LSPDP in the Sir Run Run Shaw Hospital between January 2003 and August 2013 were analyzed retrospectively. Surgical techniques for LSPDP included preservation of the splenic artery and vein (Kimura’s technique) and ligation of the splenic pedicle with preservation of the short gastric vessels (Warshaw’s technique).

RESULTS: There were no conversions to open surgery in the 38 patients. Splenic vessels were conserved during spleen-preserving pancreatectomy, except in two patients who underwent resection of the splenic vessels and preservation only of the short gastric vessels. The mean operation time was 123.2 ± 52.4 min, the mean intraoperative blood loss was 78.2 ± 39.5 mL, and the mean postoperative hospital stay was 7.6 ± 2.9 d. The overall rate of postoperative complications was 18.4% (7/38), and the rate of clinical pancreatic fistula was 13.2% (5/38). All postoperative complications were treated conservatively. The postoperative pathological diagnoses were 22 cases of benign pancreatic disease and 16 cases of borderline or low-grade malignant lesions. During a median follow-up of 38 mo (range: 5-133 mo), no recurrence was observed.

CONCLUSION: LSPDP is a safe, feasible and effective procedure for the treatment of benign and low-grade malignant tumors of the distal pancreas.

Keywords: Laparoscopic surgery, Splenic preservation, Distal pancreatectomy, Pancreatic tumor, Pancreas

Core tip: Laparoscopic spleen-preserving distal pancreatectomy (LSPDP), a function-preserving minimally invasive pancreatectomy, is an ideal procedure for treating benign and low-grade malignant tumors in the distal pancreas. We report a consecutive series of 38 patients who underwent LSPDP. There were no conversions to open surgery and rate of splenic vessel preservation was high. LSPDP was found to be a safe, feasible and effective procedure for the treatment of benign and low-grade malignant tumors of the distal pancreas.