Initial Experience of Laparoscopic Distal Pancreatic Resections: A Single Institution Study with Fifteen Consecutive Cases
DOI:
https://doi.org/10.51253/pafmj.v73i6.8963Keywords:
Laparoscopic distal pancreatic resections, Pancreatic fistula, PancreatectomyAbstract
Objective: To review the initial experience of outcomes of a consecutive series of laparoscopic distal pancreatic resections are performed at a dedicated cancer hospital.
Study Design: Case series.
Place and Duration of Study: Department of Surgical Oncology at Tertiary Care Hospital, from Mar 2013 to Feb 2021.
Methodology: A retrospective review of consecutive series of patients in which distal laparoscopic pancreatic resections were performed. Data was collected through the Hospital information system (HIS), an electronic hospital database. All patients were discussed in a multidisciplinary team prior to surgery.
Results: Fifteen patients, including 4(26.6%) males with a mean age of 49.27±15.2, were planned for laparoscopic distal
pancreatectomy. Pathologically, 12(80%) tumours were malignant, while three were benign. The procedure was converted to open in 3 patients. The mean operating time was 4.6±0.57 hours, with an estimated blood loss of around 183±28. 8mls.Mean hospital stay was 5.3±1.5 days. One patient developed a Grade A pancreatic fistula. Recurrence in the liver occurred in two patients, which was managed by systemic adjuvant therapy. However, one of them died later on because of sepsis.
Conclusion: A laparoscopic distal pancreatectomy is a safe approach for distal pancreatic tumours, with minimal
complications and fast recovery in appropriate cases.
Downloads
References
Butturini G, Crippa S, Bassi C, Salvia R, Piccoli M, Pederzoli P, et
al. The role of laparoscopy in advanced pancreatic
cancerdiagnosis. Dig Surg 2007; 24: 33–37.
https://doi.org/10.1159/000100916.
Ta R, O’Connor DB, Sulistijo A, Chung B, Conlon KC. The role of
staging laparoscopy in resectable and borderline resectable
pancreatic cancer: a systematic review and meta-analysis.
Digestive Surgery 2019; 36(3): 251-260.
https://doi.org/10.1159/000488372.
Tao LY, Chen Q, Xiu DR, Yuan CH. [Laparoscopic treatment for
pancreatic pseudocysts]. Zhonghua Wai Ke Za Zhi 2018; 56(4):
-268. Chinese.
https://doi.org/10.3760/cma.j.issn.0529-5815.2018.e004.
Miyasaka Y, Ohtsuka T, Nakamura M. Minimally invasive
surgery for pancreatic cancer. Surg Today 2021; 51(2): 194-203.
https://doi.org/10.1007/s00595-020-02120-5.
Belli A, Izzo F, Belli G. Clinical value and cost-effectiveness of
minimally invasive distal pancreatectomy. Hepatobiliary Surg
Nutr 2020; 9(2): 205. https://doi.org/10.21037/hbsn.2019.10.19.
Palanivelu C, Jani K, Senthilnathan P, Parthasarathi R,
Rajapandian S. Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg 2007; 205: 222–230.
https://doi.org/10.1016/j.jamcollsurg.2007.04.004
Okholm C, Goetze JP, Svendsen LB, Achiam MP. Inflammatory
response in laparoscopic vs. open surgery for gastric cancer.
Scand J Gastroenterol 2014; 49(9): 1027–1034.
https://doi.org/10.3109/00365521.2014.917698.
Fingerhut A, Uranues S, Khatkov I, Boni L. Laparoscopic distal
pancreatectomy: better than open?. Transl Gastroenterol Hepatol
; 1(3): 49. https://doi.org/10.21037/tgh.2018.07.04.
Lefor AK. Robotic and laparoscopic surgery of the pancreas: an
historical review. BMC Biomed Eng 2019; 1(1): 2-5.
https://doi.org/10.1186%2Fs42490-019-0001-4.
Søreide K, Olsen F, Nymo LS, Kleive D, Lassen K. A nationwide
cohort study of resection rates and short-term outcomes in open
and laparoscopic distal pancreatectomy. HPB (Oxford) 2019;
(6): 669-678. https://doi.org/10.1016/j.hpb.2018.10.006.
Coco D, Leanza S, Schillaci R, Reina GA. Laparoscopic distal
pancreatectomy for benign and malignant disease: a review of
techniques and results. Prz Gastroenterol 2022; 17(2): 103-109.
https://doi.org/10.5114/pg.2021.109625.
Durlik M, Matejak-Górska M, Jaworowski R, Kaszycka Z,
Baumgart K. Laparoscopic distal pancreatectomy. New standard
in thepancreatic surgery. Pol Przegl Chir 2013; 10: 589-597.
https://doi.org/10.2478/pjs-2013-0088.
Rosales-Velderrain A, Bowers SP, Goldberg RF, Clarke TM,
Buchanan MA, Stauffer JA, et al. National trends in resection of
the distal pancreas. World J Gastroenterol 2012; 18: 4342–4349.
https://doi.org/10.3748/wjg.v18.i32.4342.
Asbun HJ, Van Hilst J, Tsamalaidze L, Kawaguchi Y, Sanford D,
Pereira L, et al. Technique and audited outcomes of laparoscopic
distal pancreatectomy combining the clockwise approach,
progressive stepwise compression technique, and staple line
reinforcement. Surg Endosc 2020; 34(1): 231-239.
https://doi.org/10.1007/s00464-019-06757-3.
Bassi C, Dervenis C, Butturini G.: International study group on
pancreatic fistula definition. postoperative pancreatic fistula an
international study group (ISGPF) definition. Surgery 2005; 1: 8-
https://doi.org/10.1016/j.surg.2005.05.001.
Sumer A, Barbaros U, Conde SM, Celik S, Aksakal N, Alamo JM,
et al. Minimally invasive distal pancreatectomy A retrospective
review of 30 cases. Ann Ital Chir 2017;88:S0003469X17026410
Bausch D, Keck T. Minimally invasive pancreatic tumor surgery:
Oncological safety and surgical feasibility. Chirurg 2014; 8: 683-
https://doi.org/10.1007/s00104-014-2755-5.
Zhao G, Hu M, Liu R, Zhao Z, Li C, Wang F, et al. Single-port
retroperitone-oscopic pancreatectomy: preliminaryresults from
the first 3 patients. J Clin Gastroenterol 2014; 6: 559-562.
https://doi.org/10.1097/mcg.0000000000000077.
Srikanth G, Shetty N, Dubey D. Single incision laparoscopic distal pancreatectomy with splenectomy for neuroendocrine tumorof the tail of pancreas. J Minim Access Surg 2013; 3(1): 132-135.
Downloads
Published
Issue
Section
How to Cite
