Outcomes analysis of laparoscopic resection of pancreatic neoplasms

Abstract

Laparoscopic pancreatic resection is safe and feasible in selected patients with pancreatic neoplasms. With a pancreatic duct leak rate of 27%, this problem remains an area of development for the minimally invasive technique.

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.…”

Use of Bipolar Radiofrequency in Parenchymal Transection of the Liver, Pancreas and Kidney

“…Rates of pancreatic fistulas range from 16 to 30%, and the rates of those that require intervention range from 7 to 22% [30,31,32,33,34]. If these measures fail, the eventual reoperation rates for LDP are reported to be between 5 and 20% [30,32].…”

Laparoscopic distal pancreatectomy in children with solid pseudopapillary tumour (Frantz tumour) – a report of two cases and review of the literature

“…However, the number of publications and published series is small, especially in children [11,12]. This can be explained by the technical difficulty due to the complex location of the organ in the retroperitoneum, its relation to surrounding organs and major vascular structures, and to the precarious pancreatic physiology and the high risk of postoperative complications, especially pancreatic leak [10,13]. Additionally, many surgeons do not have extensive experience in pancreatic and laparoscopic surgery [14,15].…”

“…The main problems after surgery of the pancreas are pancreatic fistula, sterile collection, abscess and wound disruption, all of them believed to be due to pancreatic leakage from the stump and reaching an incidence rate of 11-27% [4,7,8,13,15,20,23]. Stapler transection of the pancreas body is the most preferred in laparoscopic pancreatic surgery [5,6,9,13,24,25].…”

“…Stapler transection of the pancreas body is the most preferred in laparoscopic pancreatic surgery [5,6,9,13,24,25]. Various other methods of pancreatic transection have been described in the literature: separate ligation of the pancreatic duct, over-sewing the pancreatic stump, mesh reinforcement of a stapled transection line, fibrin glue sealing of the stump, sealing of the parenchyma of the pancreatic stump with a radiofrequency device, patching the pancreatic stump with an omental plug or a patch taken from the falciform ligament, and the use of an ultrasonic or harmonic scalpel for tissue dissection have been advocated as successful [23][24][25].…”