Objective: To evaluate the safety, feasibility indications, prognosis and follow-up of laparoscopic distal pancreatectomy.
Methods: Retrospective study was employed on 10 patients collected from Feb. to Oct. 2005 with diagnosis of masses located at pancreatic body/tail. The mean age was 43 years and ratio between male and female was 1:9. Preoperative diagnosis: nine patients with cystic lesion located at pancreatic body and tail, one patient with pancreatic endocrine tumor with liver metastasis, which located at pancreatic tail. The mean size of the tumor was 4.0 cm. All patients received adjuvant examinations including CT contrast scan, abdominal ultrasound or endoscopic ultrasound. The serum levels of tumor markers (including CA19-9, CA242, CA50 and CEA) of the patients were all normal.
Results: All patients received distal pancreatectomy by laparoscope successfully. Among them, seven procedures were spleen-preserved and three with splenectomy. Mean operative time was 228 +/- 26 min, and mean blood lose volume was 173 +/- 100 ml. One patient suffered with pancreatic fistula after operation but was successfully managed by conservative therapy in one month, pancreatic pseudocyst was detected in one patient and disappeared spontaneously in one month, no other morbidity occurred. The postoperative hospital stay was 12 - 16 d (mean, 13.5 d). The serum glucoses of 10 patients after operation were normal. The mean time of follow-up was 8 months (2 - 22 months). During the follow-up, nine patients with benign cystic lesions did not relapse. And the other one patient with malignant metastasis kept stable, not recurrence was detected in one year after operation.
Conclusions: Laparoscopic distal pancreatectomy was safe and feasible for benign cystic tumors located at the body or tail of the pancreas.