Pankreaslinksresektion

Chromik, Ansgar M.; Janot, M; Sülberg, D.; Seelig, Matthias H.; Uhl, W.

doi:10.1007/s00104-008-1573-z

Cited by 13 publications

(2 citation statements)

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“…The first laparoscopic distal pancreatectomy (LDP) was published by Gagner in 1994 . Because of the small number of cases performed in different centres, this approach is still not considered a routine procedure . This, in turn, is the result of the small number of entities suitable for the procedure, as well as the technical complexity.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic spleen‐preserving distal pancreatectomy: A consecutive series at an experienced centre

Schloericke¹,

Zimmermann²,

Roblick³

et al. 2012

Surgical Practice

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Aim The increasing experience within the area of laparoscopic procedures has paved the way for technically‐complex procedures, such as distal pancreatectomy. In order to avoid complications associated with concomitant splenectomy, these procedures are increasingly performed with spleen preservation. A drawback is the low number of cases, which does not allow for an evidence‐based comparison between laparoscopic and open procedures, and spleen‐preserving and concomitant splenectomy procedures. Patients and Methods Between 2006 and 2010, all data for patients who underwent a laparoscopic distal pancreatectomy (LDP) at the Department of Surgery, University of Schleswig‐Holstein, Luebeck, Germany, were collected are stored in a prospectively‐maintained database. Patients with tumours in the pancreatic tail and body that did not exceed the level of the portal vein were included in this database. Results A total of 22 patients who underwent LDP could be included in the evaluation. Ten of those patients underwent a laparoscopic spleen‐preserving distal pancreatectomy (LSPDP), while the remaining 12 received an LDP with splenectomy (LDPwS). The median operation time was 155 min (range: 98–253) for the LSPDP group, and 201 min (range: 60–310) for the LDPwS group (P = 0.06). The median hospital stay was 8.5 days (range: 5–23) in the LSPDP group compared to 11 days (range: 4–41) in the LDPwS group (P = 0.06). Pancreatic fistula occurred in two patients from each group. It caused an intraabdominal haemorrhage in one patient of the LSPDP group, which required re‐laparoscopy. Two patients experienced subphrenic abscesses in the LDPwS group and were treated interventionally. Histological examination revealed six cystadenomas and five pseudocysts (maximum diameter: 7 cm) in the LDPwS group, and six neuroendocrine tumours (maximum diameter: 2 cm) in the LSPDP group. Conclusion LDP can be performed safely. The optic magnification provided by laparoscopy facilitates LSPDP, as dissection of the splenic vessels can be avoided. Although not significant, there was a trend towards reduced hospital stay and operating time for LSPDP. Oncologic outcomes and morbidity seem to not be inferior to open procedures. The size of the tumours and the peripancreatic, as well as paraneoplastic, tissue alterations determine the indication for splenectomy.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic spleen‐preserving distal pancreatectomy: A consecutive series at an experienced centre

Schloericke¹,

Zimmermann²,

Roblick³

et al. 2012

Surgical Practice

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“…The standard resection for tumors of the body and tail of the pancreas is a distal pancreatectomy with concomitant splenectomy [7]. Distal pancreatectomy with en bloc resection of the celiac artery has broadened the operative spectrum in pancreatic surgery.…”

Section: Introductionmentioning

confidence: 99%

Extended Distal Pancreatectomy with En Bloc Resection of the Celiac Axis for Locally Advanced Pancreatic Cancer: A Case Report and Review of the Literature

Alizai

Mahnken

Klink

et al. 2012

Case Reports in Medicine

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Due to a lack of early symptoms, pancreatic cancers of the body and tail are discovered mostly at advanced stages. These locally advanced cancers often involve the celiac axis or the common hepatic artery and are therefore declared unresectable. The extended distal pancreatectomy with en bloc resection of the celiac artery may offer a chance of complete resection. We present the case of a 48-year-old female with pancreatic body cancer invading the celiac axis. The patient underwent laparoscopy to exclude hepatic and peritoneal metastasis. Subsequently, a selective embolization of the common hepatic artery was performed to enlarge arterial flow to the hepatobiliary system and the stomach via the pancreatoduodenal arcades from the superior mesenteric artery. Fifteen days after embolization, the extended distal pancreatectomy with splenectomy and en bloc resection of the celiac axis was carried out. The postoperative course was uneventful, and complete tumor resection was achieved. This case report and a review of the literature show the feasibility and safety of the extended distal pancreatectomy with en bloc resection of the celiac axis. A preoperative embolization of the celiac axis may avoid ischemia-related complications of the stomach or the liver.

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