Safety and Feasibility of Single Incision Laparoscopic Spleen Preserving Distal Pancreatectomy

ABSTRACT

PURPOSE: Single-incision laparoscopic distal pancreatectomy (SIL-DP) has recently been attempted in the treatment of left-sided benign neoplasms of the pancreas. This study was conducted to evaluate the perioperative outcomes of SIL-DP compared with conventional laparoscopic DP (CL-DP). METHODS: Patients who received laparoscopic DP from a single surgeon for benign pancreatic neoplasm from January 2012 to January 2014 were included. The patients were divided into two groups, SIL-DP and CL-DP. We used four trocars for CL-DP and a custom-made glove port for SILDP and analyzed the conversion cases separately. Perioperative outcomes were compared between types of surgery. RESULTS: SIL-DP was attempted in 13 patients, five of whom required conversion to CL-DP or dual-incision surgery. CL-DP was attempted in 27 patients and all were successful without open conversion. The spleen was preserved in all patients who underwent SIL-DP without conversion, in four of five (80%) in the conversion group, and 21 (78%) of those who underwent CL-DP. The complication rate was 13% in the SIL-DP-only group, 60% in the conversion group, and 19% in the CL-DP group. The operation time, estimated blood loss, numeric pain intensity score, and hospital duration were similar in the SIL-DP and CL-DP groups. CONCLUSION: SIL-DP was associated with a moderate need for an additional port, and the complication rate was high in the conversion group. Our findings indicate that SIL-DP should be attempted carefully. Further studies are needed to evaluate the lon g term follow-up outcomes of SIL-DP.