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Laparoscopic pancreatic surgery: current indications and surgical results.
- Source :
-
Surgical endoscopy [Surg Endosc] 2004 Mar; Vol. 18 (3), pp. 402-6. Date of Electronic Publication: 2004 Jan 23. - Publication Year :
- 2004
-
Abstract
- Background: Although minimally invasive surgery has achieved worldwide acceptance in various fields, laparoscopic surgery for pancreatic diseases has been reported only rarely. The purpose of this study was to evaluate the outcomes and feasibility of laparoscopic pancreatic surgery.<br />Methods: Fifteen patients, comprising eight men and seven women with an average age of 54 years, underwent laparoscopic pancreatic surgery. Distal pancreatectomy was indicated for solid tumors ( n = 4), cystic lesions ( n = 3), and chronic pancreatitis ( n = 2). Cystogastrostomy was performed for pseudocysts ( n = 4) and enucleation for insulinomas ( n = 2). The lesions varied in size from 1 to 9 cm (2.9 +/- 2.4 cm) and were located in the pancreatic head ( n = 2), body ( n = 3), or tail ( n = 10). For distal pancreatectomy, the splenic artery was divided and the parenchyma was transected with a linear stapler. Laparoscopic ultrasonography was used to determine the distance between the tumor and the main pancreatic duct for enucleation as well as to localize the lesion for distal pancreatectomy. Cystogastrostomy, 4.5 cm in length, was also performed with the linear stapler through the window of the lesser omentum.<br />Results: Mean operation time was 249 +/- 70 min (293 +/- 58 min in distal pancreatectomy, 185 +/- 14 min in enucleation, 204 +/- 50 min in cystogastrostomy), and mean blood loss was 138 +/- 184 g (213 +/- 227 g, 75 +/- 35 g, 38 +/- 48 g, respectively). Two distal pancreatectomies (13%) were converted to open surgery due to severe peripancreatic inflammation. There was no related mortality, but there were two cases (15%) of pancreatic fistula, one in a distal pancreatectomy case and the other in an enucleation case, and both were treated conservatively.<br />Conclusions: Laparoscopic pancreatic surgery is safe and feasible for patients with benign tumors and cystic lesions.
- Subjects :
- Adult
Aged
Cystadenoma surgery
Diagnostic Imaging
Female
Humans
Insulinoma surgery
Japan
Laparoscopy statistics & numerical data
Male
Middle Aged
Minimally Invasive Surgical Procedures statistics & numerical data
Neuroendocrine Tumors surgery
Pancreatectomy statistics & numerical data
Pancreatic Cyst surgery
Pancreatic Diseases diagnosis
Pancreatic Neoplasms surgery
Pancreatic Pseudocyst etiology
Pancreatic Pseudocyst surgery
Pancreatitis complications
Pancreatitis surgery
Retrospective Studies
Treatment Outcome
Ultrasonography, Interventional
Laparoscopy methods
Pancreatectomy methods
Pancreatic Diseases surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 18
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 14735345
- Full Text :
- https://doi.org/10.1007/s00464-003-8164-3