Laparoscopic pancreatic resections in two medium-sized medical centres

To analyze the clinical outcomes of patients undergoing minimally invasive surgery for pancreatic neoplasms, in two medium-volume centers in Northern Italy, a retrospective chart review was performed in the operative registries, searching for patients who had undergone pancreatic surgery via laparoscopy, irrespective of the final pathological nature of the resected neoplasm. For each case, a standard data extraction form was completed and the following data was extracted: age and sex, type of resection, estimated blood loss, length of the operation, number of harvested nodes, post-operative pancreatic fistula, major post-operative complications, mortality and final pathological diagnosis. The systematic literature research was also undertaken and the reported results were analyzed. A total of 55 cases were recorded, including 39 distal pancreatectomies and 16 pancreaticoduodenectomies. The most frequent indications leading to surgery were ductal adenocarcinoma (26 pts) and cystic neoplasm (22 pts). No post-operative death occurred in this series; pancreatic fistula occurred in 64% of distal pancreatectomies and 22% of pancreaticoduodenectomies. The mean operating times were 178' and 572', respectively. Both distal pancreatectomy and pancreaticoduodenectomy proved to be feasible and were safely performed by laparoscopy, in two centers with medium-volume pancreatic caseload.