Laparoscopic spleen-preserving distal pancreatectomy in the treatment of pancreatic benign and borderline tumors / 中华肝胆外科杂志

ABSTRACT

Objective To study the safety and feasibility of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) in the treatment of pancreatic benign and borderline tumors.Methods The clinical data of 15 patients with preoperative diagnoses of pancreatic benign or borderline tumors who underwent LSPDP in the Jinhua Hospital,Zhejiang University from March 2013 to March 2017 were retrospectively analyzed.The diameter of tumors ranged from 2.6 to 6.8 cm,with an average of 4.4 cm.Results 15 patients were successfully treated with LSPDP.Twelve patients underwent splenic vessels preservation and 3 without splenic vessels preservation.The average operation time was 215 min (160 ～ 270 min).The mean intraoperative blood loss was 340 ml (180 ～700 ml),and the average postoperative hospital stay was 10.5 days (7 ～ 16 days).There was no patient with postoperative abdominal hemorrhage.Three patients developed postoperative pancreatic fistula and they were treated successfully with conservative therapy.Two patients developed splenic infarction,and the splenic infarction improved markedly after two months on CT.The pathological diagnoses showed 9 patients with serous cystadenoma,4 patients with mucinous cystadenoma,1 patient with a pancreatic neuroendocrine tumor and 1 patient with a solid pseudopapillary tumor.There was no recurrence on follow-up which ranged from 6 to 24 months.Conclusions Laparoscopic spleen-preserving distal pancreatectomy was safe and feasible in the treatment of pancreatic benign or borderline tumors.The Kimura procedure should be performed in preference to the Warshaw procedure.