Laparoscopic Spleen Preserving Distal Pancreatectomy with the Conservation of the Splenic Artery and the Vein

ABSTRACT

Until now, there have been few reports of laparoscopic spleen preserving distal pancreatectomies with the conservation of the splenic vessels. We experienced two cases of a laparoscopic spleen preserving distal pancreatectomy, with the conservation of the splenic artery, vein and short gastric vessels. One case was in a 52 years old woman. The patient was preoperatively diagnosed with a nonsymptomatic cystadenoma, which measured 7 cm in diameter at the tail of pancreas. The procedure used was a 70% distal pancreatectomy, with preservation of the spleen, including the splenic vessels. Three 10 mm ports, one 15mm port and one linear stapler (EndoGIA60(R)) were used for the procedure. A 3 cm incision, extending 15 mm to the trocar site, was used for the extraction of the specimen. The total operative time was 435 minutes. The patient was discharged on the 8th postoperative day with no problems. The other case was in a 61 years old woman. The patient was preoperatively diagnosed with a symptomatic cystadenoma, which measured 3 cm in size at the body of the pancreas. The procedure used was an 85% distal pancreatectomy, employed the same method as the previous case, with the exception that an EndoGIA30(R) was used for the resection of pancreas in place of the EndoGIA60(R). The total operative time was 400 minutes. The patient was discharged on 9th postoperatvie day, with no problems. There was no morbidity and mortality during hospitalization. A laparoscopic spleen splenic vessels, could be an alternative treatment in selective preserving distal pancreatectomy with the conservation of the patients with benign pancreatic neoplasms.