Experience in laparoscopic distal pancreatosplenectomies

Abstract

Background: Distal pancreatectomy with or without splenectomy is a surgical technique to approach lesions of the left pancreas.
Objective: To analyze our experience in laparoscopic distal pancreatosplenectomies with evaluation of results and benefits.
Material and methods: We performed a retrospective and observational study of 17 patients operated on from 2017 to 2020.
Results: 47.10% were men (n = 8) and 52.90% were women (n = 9). The most common reasons for consultation were incidental tumors in 52.94% (n = 9); abdominal pain in 48.06% (n = 8). The diagnostic imaging tests performed were abdominal ultrasound and computed tomography scan of the abdomen and were complemented with other high-complexity studies. The preoperative diagnoses were SCN (11.76%; n = 2), MCN (5.88%; n = 1), pancreatic pseudocyst (11,76%; n = 2); malignant tumor and NET (17.66; n = 3). The mean size of the tumors was 4.26 cm (range 2-10 cm). Conversion rate was 23.08% (n = 3). Median operative time was 270 minutes. The complications observed were subdivided in minor and major. Two patients were readmitted and there were no cases or mortality or reoperations.
Discussion: Laparoscopy is a safe and efficient approach for benign and malignant tumor s of the pancreas in selected cases. Biochemical leak, pancreatic fistula and morbidity rate are similar to those reported by other series of laparoscopic pancreatic resections. We did not find significant differences between the treatment of the pancreatic stump and the risk of fistula.