Related Experiment Video
Updated: Sep 12, 2025
Laparoscopic Radical Left Pancreatectomy for Pancreatic Cancer: Surgical Strategy and Technique Video
Published on: June 6, 2020
Surgical approach and postoperative outcomes after left pancreatectomy (Spandispan prospective project)
Belén Hernández-Roca1, José M Ramia2, Juli Busquets3
1Servicio de Cirugía General, Hospital General Universitario de Elda, Elda, Alicante, Spain.
Introduction:
Left pancreatectomy (LP) is a surgical technique with low mortality but high morbidity (30%), particularly pancreatic fistula (PF). Its minimally invasive (MI) approach has become popular, but its implementation in Spain remains unknown. We present a national multicentre study on LP to determine morbidity-mortality, PF incidence, and the percentage of MI approach.
Methods:
A descriptive, observational, prospective, and multicentre study on LP.
Study Period:
02/01/2022-02/28/2023.
Inclusion Criteria:
Elective LP.
Exclusion Criteria:
LP following pancreaticoduodenectomy, with celiac trunk resection, or performed as an emergency. Major complications (MC): Clavien-Dindo ≥ IIIA.
Results:
A total of 41 centres participated, including 313 patients. Women accounted for 53.4%. Mean age: 63.4 years. The most common indications for LP were neuroendocrine tumours (32.6%), pancreatic adenocarcinoma (28%), and IPMN (15.7%). The surgical approach was laparoscopic (53%), open (30.7%), and robotic (16.3%). The most frequently performed techniques were distal splenopancreatectomy (72.2%) and radical antegrade modular pancreatosplenectomy (RAMPS) (14.4%). Complications occurred in 57.5% of patients, with 21.1% classified as MC. The most frequent was PF (38.3%), with 52.5% of PFs classified as B-C (20.1% of the total). The 90-day mortality rate was 1.6%. The use of a protective sleeve and the absence of drains were associated with the absence of PF in multivariate analysis.
Conclusion:
In our series, the MI approach was significantly higher than expected (70%). The MC rate was 21.1%, and mortality was 1.6%, confirming that LP is a procedure with low mortality but high morbidity.
