Technical aspects of distal pancreatectomy with splenic preservation
Due to increased experience in laparoscopic surgery and the availability of new technological devices, Laparoscopic distal pancreatectomy (LDP) has gained worldwide acceptance, and is currently accepted as an alternative to the open thecnique in the treatment of distal pancreatic tumors. In patients with benign or low grade malignancies, LDP is described as a feasible and safe procedure. Decreased blood loss and morbidity, early recovery and shorter hospital stay are some of the main advantages of this approach. However, there is no standardized thecnique for this procedure. The authors present the thecnical aspects of LDP with spleen and splenic vessels preservation, highlighting some important aspects of this approach, in order to potencially optimize its results.
Gagner M, Pomp A, Herrera MF. Early experience with laparoscopic resections of islet cell tumors. Surgery. 1996;120:1051-1054.
Kooby DA, Hawkins WG, Schmidt CM, et al. A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 2010; 210:779—85 [786—7].
Marangos IP, Buanes T, Røsok BI, et al. Laparoscopic resection of exocrine carcinoma in central and distal pancreas results in a high rate of radical resections and long postoperative survival. Surgery 2012; 151:717—23.
KunXie, Yi-Ping Zhu, Xiao-Wu, et al. Laparoscopic distal pancreatectomy is safe and feasible as open procedure: A meta-analysis. World J Gastroenterol 2012; 18(16): 1959-1967
Iacobone M, Citton M, Nitti D. Laparoscopic distal pancreatectomy: Up to-to-date and literature review. World J Gastroenterol 2012; 18 (38): 5329-5337
Mabrut JY, Fernandez-Cruz L, Azagra JS, et al. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005; 137: 597– 605.
Mohkam K, et al. Toward a standard technique for laparoscopic distal pancreatectomy? Synthesis of the 2013 ACHBT Spring workshop. Journal of Visceral Surgery. 2015
Sato Y, Shimoda S, Takeda N, Tanaka N, Hatakeyama K. Eval- uation of splenic circulation after spleen-preserving distal pancreatectomy by dividing the splenic artery and vein. Dig Surg 2000; 17:519—22.
Carrère N, Abid S, Julio CH, Bloom E, Pradère B. Spleen- preserving distal pancreatectomy with excision of splenic artery and vein: a case-matched comparison with conven- tional distal pancreatectomy with splenectomy. World J Surg. 2007; 31:375—82.
Ferrone CR, Konstantinidis IT, Sahani DV, Wargo JA, Fernández del Castillo C, Warshaw AL. Twenty-three years of the Warshaw operation for distal pancreatectomy with preservation of the spleen. Ann Surg. 2011; 253:1136—9.
W. Kimura, T. Inoue, N. Futakawa, H. Shinkai, I. Han, and T. Muto, “Spleen-preserving distal pancreatectomy with conserva- tion of the splenic artery and vein,” Surgery, vol. 120, no. 5, pp. 885–890, 1996.
J.A.M.G. Tol, D. J. Gouma, C. Bassi et al., “Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS),” Surgery, vol. 156, no. 3, pp. 591–600, 2014.
Sepsi B, Moalem J, Galka E, Salzman P, Schoeniger LO. The influence of staple size on fistula formation following distal pancreatectomy. J Gastrointest Surg 2012;16:267-74.
H. J. Asbun and J. A. Stauffer, “Laparoscopic approach to distal and subtotal pancreatectomy: a clockwise technique,” Surgical Endoscopy and Other Interventional Techniques, vol. 25, no. 8, pp. 2643–2649, 2011.
C. Bassi, C. Dervenis, G. Butturini et al., “Postoperative pancreatic fistula: an international study group (ISGPF) definition,” Surgery, vol. 138, no. 1, pp. 8–13, 2005.
T. de Rooij, R. Sitarz, O. R. Busch, M. G. Besselink, M. Abu Hilal., “Technical aspects of laparoscopic distal pancreatectomy for benign and malignant disease: review of the literature”, Gastroenterol Research and Practice, Vol. 2015, 472906, pp. 1- 9, 2015.