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Laparoscopic pancreatic resection: Is it worthwhile?

M Gagner1, A Pomp

  • 1Department of General Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|January 1, 1997
PubMed
Summary
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Laparoscopic distal pancreatectomy and enucleation offer benefits over the laparoscopic Whipple procedure, with shorter hospital stays and no disease recurrence. The Whipple procedure showed no clear advantages in this small study.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic pancreatic surgery is increasingly utilized for various pathologies.
  • The Whipple procedure, distal pancreatectomy, and enucleation are key surgical options.
  • Comparative outcomes of these laparoscopic approaches require further investigation.

Purpose of the Study:

  • To evaluate the outcomes of laparoscopic Whipple, distal pancreatectomy, and enucleation.
  • To compare the efficacy and safety of these laparoscopic pancreatic procedures.
  • To identify potential benefits of specific laparoscopic pancreatic surgical techniques.

Main Methods:

  • Retrospective review of 23 patients undergoing attempted laparoscopic Whipple, distal pancreatectomy, or enucleation since 1992.

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  • Analysis of patient demographics, operative details, conversion rates, complications, operative time, and hospital stay.
  • Categorization of patients based on the specific laparoscopic pancreatic procedure performed.

    • Main Results:

    • Laparoscopic Whipple procedure had a 40% conversion rate, 8.5-hour operative time, and 22.3-day hospital stay, with complications in the non-converted group.
    • Laparoscopic distal pancreatectomy (n=9) and enucleation (n=4) had a 36% conversion rate, with shorter operative times (4.5 and 3 hours, respectively) and significantly shorter hospital stays (5 and 4 days).
    • No recurrence of disease was noted in the laparoscopic distal pancreatectomy and enucleation groups.

    Conclusions:

    • Laparoscopic distal pancreatectomy and enucleation appear technically easier and offer patient benefits, including reduced hospital stay.
    • The complete laparoscopic Whipple procedure did not demonstrate clear advantages in this small patient series.
    • Further research with larger cohorts is warranted to confirm the benefits of laparoscopic distal pancreatectomy and enucleation.