Laparoscopic duodenum and spleen-preserving total pancreatectomy: A novel surgical technique for pancreatic intraductal papillary mucinous neoplasms

Wu, Jia; Hu, Qirong; Jin, Liming; Yao, Weifeng; Zhang, Chengwu; Hu, Zhiming; Zhang, Yuhua

doi:10.5582/bst.2019.01271

BST

2019

DOI: 10.5582/bst.2019.01271

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Laparoscopic duodenum and spleen-preserving total pancreatectomy: A novel surgical technique for pancreatic intraductal papillary mucinous neoplasms

Jia Wu

Qirong Hu²,

Liming Jin

et al.

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2024

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Cited by 3 publications

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A novel surgical approach for en-bloc resection laparoscopic total pancreatectomy

Cai

Gao²,

Peng

2020

Medicine

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Laparoscopic total pancreatectomy (LTP) is technical challenging and rarely reported in the literature. Herein, we introduced a safe and feasible approach to perform LTP basing on our own experience. Over the period of July 2015 to August 2018, we performed 13 cases of LTP at our institution. Demographic characteristics, intraoperative and postoperative variables, and follow-up outcomes were prospectively collected. The surgical procedures were also described in this study. Seven male and six female patients were included in this study. The median age of the patients was 51 years (range 29–79 years). The median operative time was 355 minutes (range 300–470 minutes). The median estimated blood loss was 200 mL (range 50–1000 mL). The median postoperative hospital stay was 17 days (range 12–23 days). One patient suffered from bile leakage and another patient suffered from delayed gastric emptying. Both patients cured with conservative therapy. Laparoscopic total pancreatectomy can be safely and feasibly performed in well-selected patients.

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A novel surgical approach for en-bloc resection laparoscopic total pancreatectomy

Cai

Gao²,

Peng

2020

Medicine

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Laparoscopic Duodenum and Spleen-Preserving Subtotal or Total Pancreatectomy: A Parenchyma-Sparing Strategy for Main Duct Intraductal Papillary Mucinous Neoplasms (with Video)

Li,

Shi,

Tang

et al. 2024

Ann Surg Oncol

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Background For premalignant main duct intraductal papillary mucinous neoplasms (MD-IPMN), laparoscopic duodenum and spleen-preserving subtotal or total pancreatectomy (LDSP-STP/TP) seems to be a viable option for parenchyma-sparing pancreatectomy. Patients and Methods On the basis of the imaging features, family history, genomic alterations, intraoperative ultrasound examination, and frozen section evaluation, we have proposed patient selection strategies for the LDSP-STP/TP technique for the first time. Additionally, a comprehensive step-by-step overview of this technique has been provided. To date, we have performed five LDSP-STP procedures and one LDSP-TP procedure. Results We successfully performed selective resection of the affected pancreatic parenchyma while preserving the duodenum, common bile duct (CBD), spleen, and splenic artery and vein. The operation time ranged from 295 to 495 min, with blood loss ranging from 100 to 300 mL. Postoperative pathological results revealed low-grade dysplasia in the resected pancreatic samples and margins. The patients resumed eating within 3–5 days after surgery, and all postoperative complications were classified as grade I according to the Clavien–Dindo classification. At the 3-month follow-up, there were no cases of CBD ischemic stenosis, splenic ischemia, or pseudocyst formation observed. For patients who received LDSP-STP, the longitudinal diameter of the remaining pancreatic tail ranged from 2.2 to 4.6 cm, and they demonstrated satisfactory long-term blood glycemic control. Conclusions LDSP-STP/TP demonstrates technical feasibility and safety. It allows for the selective resection of the affected pancreatic parenchyma, thereby minimizing the impact of pancreatic functional impairment. However, it is crucial to validate this technique through long-term prospective observations.

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Laparoscopic spleen-preserving total pancreatectomy for the treatment of low-grade malignant pancreatic tumors: Two case reports and review of literature

Sun,

Kang,

et al. 2024

World J Clin Cases

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BACKGROUND Function-preserving pancreatectomy can improve the long-term quality of life of patients with benign or low-grade malignant tumors, such as intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms. However, there is limited literature on laparoscopic spleen-preserving total pancreatectomy (L-SpTP) due to technical difficulties. CASE SUMMARY Patient 1 was a 51-year-old male diagnosed with IPMN based on preoperative imaging, showing solid nodules in the pancreatic head and diffuse dilation of the main pancreatic duct with atrophy of the distal pancreas. We performed L-SpTP with preservation of the splenic vessels, and the postoperative pathology report revealed IPMN with invasive carcinoma. Patient 2 was a 60-year-old male with multiple cystic lesions in the pancreatic head and body. L-SpTP was performed, and intraoperatively, the splenic vein was injured and required ligation. Postoperative pathology revealed a mucinous cystic tumor of the pancreas with low-grade dysplasia. Both patients were discharged on postoperative day 7, and there were no major complications during the perioperative period. CONCLUSION We believe that L-SpTP is a safe and feasible treatment for low-grade malignant pancreatic tumors, but more case studies are needed to evaluate its safety, efficacy, and long-term outcomes.

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Laparoscopic duodenum and spleen-preserving total pancreatectomy: A novel surgical technique for pancreatic intraductal papillary mucinous neoplasms

Cited by 3 publications

References 13 publications

A novel surgical approach for en-bloc resection laparoscopic total pancreatectomy

A novel surgical approach for en-bloc resection laparoscopic total pancreatectomy

Laparoscopic Duodenum and Spleen-Preserving Subtotal or Total Pancreatectomy: A Parenchyma-Sparing Strategy for Main Duct Intraductal Papillary Mucinous Neoplasms (with Video)

Laparoscopic spleen-preserving total pancreatectomy for the treatment of low-grade malignant pancreatic tumors: Two case reports and review of literature

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