Laparoscopic distal pancreatic resection: Report of 23 cases

Objective To study the feasibility,safety,techniques and indications of laparoscopic distal pancreatic resection（LDPS）. Methods Twenty-three patients（8 males,15 females） with a mean age of（45.2±11.75）years who underwent LDPS from March 2003 to February in our department were retrospectively analyzed.Of the 23 patients,21 were diagnosed as benign lesion and 2 as malignant lesion. Results Of the 23 patients,21 were successfully operated and 2 were transferred to laparotomy.Laparoscopic distal pancreatic resection was performed with spleen removed and reserved in 15 and 8 patients,respectively.The operation time was（184.6±122.7）min with a blood loss of（189.8±256.32）ml.Pancreatic fistula occurred in 3 patients,which was cured by delaying drainage time in 2 patients and by ultrasound-guided puncture and drainage in 1 patient.The mean oral food taking time was（3.79±1.25）d and the mean hospital stay time was（8.28±2.40）d after operation.Pathological examination showed insulinoma in 13（multiple insulinomas in 1）,nonfunctional islet cell tumor in 2,cystadenoma in 4,accessory spleen in 1,and adencarcinoma in 2（moderately-differentiated in 1 and well-differentiated in 1） patients,respectively.The mean follow-up time was（28.79±19.25） months during which 1 patient developed type 2 diabetes mellitus,1 patient died 6 months after operation,1 patient developed cerebral thrombosis 7 months after operation.The rest 22 patients were still alive with no recurrence of tumor. Conclusion LDPS is a safe procedure for benign,boundary and early malignancies in distal pancreas.