Pure laparoscopic middle pancreatectomy: single-center experience with 13 cases

Laparoscopic pancreatic surgery is performed with increasing frequency, but laparoscopic middle pancreatectomy (LMP) is rarely described. This study aimed retrospectively to describe the authors' unicentrically and prospectively collected data at a specialized center.

Since July 2011, 13 patients have undergone LMP. In this study, all their demographics and operative and postoperative data were studied from a prospectively maintained database.

The study included eight women and five men with a mean age of 51 (range 27-75 years) and a body mass index of 26 kg/m(2) (range 22-32 kg/m(2)). The main indications were neuroendocrine tumor (n = 7), intraductal papillary mucinous neoplasia (n = 2), solid pseudopapillary tumor (n = 2), and other (n = 2). The median duration of surgery was 190 min (range 120-285 min), and the mean blood loss was 100 ml (range 50-800 ml). Only one conversion was performed (8 %). The postoperative outcomes showed no mortality. Clinically significant pancreatic fistula (B and C) were found in 30 % of the cases. Bleeding was observed in two patients (15 %) and reintervention in three patients (23 %). The median hospital stay was 24 days (range 14-53 days), with no readmissions. The long-term follow-up evaluation showed no endocrine insufficiency and only one endocrine insufficiency (8 %).

LMP is a safe surgical procedure allowing a minimally invasive approach for low malignant-potential lesions and offering a postoperative outcome comparable with that of the open approach.