Laparoscopic distal pancreatectomy: critical analysis of preliminary experience from a tertiary referral centre

Abstract

Laparoscopic distal pancreatic resection is feasible, safe, and efficient. However, this surgery should only be performed in specialized centres with extensive experience in pancreatic and laparoscopic surgery. Oversewing the pancreatic stump after transaction with Endostapler may reduce the incidence of pancreatic leak. Centralization of pancreatic surgery has a positive impact on building up surgical expertise, resulting in obvious benefits for both patients and institutions.

Optimal Technical Management of Stump Closure Following Distal Pancreatectomy: A Retrospective Review of 215 Cases

“…To date, most reports of laparoscopic distal pancreatectomy are small series from single institutions. [33][34][35][36][37][38] The occurrence of pancreatic fistula following laparoscopic distal pancreatectomy in these studies has been reported as ranging from 13-50%. 39 In our series, laparoscopic distal pancreatectomy was attempted in 16 patients and completed in 13 patients.…”

Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: A two-center comparative study

“…The technique for LDP has been described elsewhere (Abu Hilal et al, 2009). In short, five ports (three 5-mm ports and two 10/12-mm ports) were used.…”

Laparoscopic distal pancreatectomy

“…It is not necessary for the surgeon's hand to feel the borders of the lesion. Most authors advocate the use of intraoperative laparoscopic ultrasound to localize the lesion and define the extent of the resection (30). If the lesion is obvious, dissection is initiated by mobilizing the lower pancreatic margin 2 cm proximal to the lesion.…”

“…With increasing experience and specialized centers, the conversion rates are expected to decrease. The most common reasons for conversion are obesity, dense omental fat, intraoperative bleeding, malignant disease requiring lymph node dissection, inability to detect the tumor, bulky tumors, and peritoneal adhesions due to previous surgery (30).…”