Preservation of splenic vessels during laparoscopic spleen-preserving distal pancreatectomy via lateral approach

Wideochir Inne Tech Maloinwazyjne. 2015 Sep;10(3):382-8. doi: 10.5114/wiitm.2015.54188. Epub 2015 Sep 16.

Abstract

Introduction: Preserving splenic vessels during laparoscopic distal pancreatectomy (SPDP-LA) is feasible and avoids unnecessary splenectomy.

Aim: To present our outcomes for this unique technique.

Material and methods: Between January 1998 and January 2012, 6 patients who underwent SPDP-LA for benign or low malignancy tumors in the pancreatic tail were included. Clinical characteristics as well as perioperative data were retrospectively recorded.

Results: All procedures were successful, with an average operative time of 184 min (range: 88-277 min) and average blood loss of 401.7 ml (range: 10-900 ml). The mean hospital stay was 7 days. Pancreatic fistula occurred in 2 patients but was then cured by external drainage. There was no mortality. Follow-ups were available for all patients.

Conclusions: Our experience was characterized by a lack of conversions and by acceptable rates of postoperative fistula and morbidity. The lateral approach showed beneficial results in patients without complications and short post-operative hospital stays.

Keywords: distal pancreatectomy; laparoscopic surgery; lateral approach; spleen preserving; splenic infarction.