Laparoscopic distal pancreatectomy with splenic preservation

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Distal pancreatectomy can be performed with or without splenic preservation.
• Splenic preservation is desirable but technically challenging in laparoscopic approaches.
• Ligation of splenic vessels is an alternative to vessel skeletonization for splenic preservation.

Purpose of the Study:

• To report the experience with splenic preservation during laparoscopic pancreatic resection.
• To evaluate the safety and efficacy of ligating splenic vessels for splenic preservation.

Main Methods:

• Retrospective chart review of patients undergoing laparoscopic pancreatic resection.
• Analysis of demographic data, operative details, splenic preservation rates, and complications.
• Focus on technique involving splenic vessel ligation and short gastric vessel preservation.

Main Results:

• Eight of 12 patients (67%) achieved splenic preservation.
• Common indications included neuroendocrine tumors, cystic neoplasms, and pancreatitis.
• Complications included chemical leaks (25%) and higher volume leaks (25%); no conversions for malignancy.
• Average blood loss was 215 ml, operative time 3h 41min, and hospital stay 4 days.

Conclusions:

• Splenic preservation should be pursued when technically feasible to reduce morbidity.
• Ligating splenic vessels is associated with shorter operative times and minimal perioperative complications.
• This technique allows for successful splenic preservation during laparoscopic distal pancreatectomy.