Spleen-preserving laparoscopic distal pancreatectomy: Two cases and review of the technique
Koray Topgül1, S. Savaş Yürüker2, Bülent Koca2, Tuğrul Kesicioğlu2
1Medical Park Samsun Hospital, Department of General Surgery, Samsun, Turkey
2Ondokuz Mayıs University School of Medicine, Department of General Surgery, Samsun, Turkey
In this study, we aimed to assess the technique and results of spleen-preserving laparoscopic distal pancreatectomy (SPLDP) on the basis of two cases. The first case was a woman with a large cystic papillary lesion of the distal pancreas. The other patient was a woman with a pancreatic mass on the tail of the pancreas. Both patients were operated on using SPLDP. Five trocars were used in the first case and four trocars were used in the second case. Thirty degree telescope visualization and LigaSure dissection were used during the operation. The splenic vessels were dissected, but the short gastric vessels were preserved. The pancreas was transected by one Endo GIA stapler and the cut edge of the pancreas was reinforced with sutures to prevent a pancreatic fistula. We performed the same technique in both cases. However, in the first case, we aspirated the content of the cystic mass of the pancreas before removing it to avoid making a large incision. The duration of the operation was 190 and 135 minutes, respectively. There were no postoperative complications. SPLDP is a safe, effective modality for managing lesions of the distal pancreas. If the splenic vessels are transected, the short gastric vessels must be protected to ensure the viability of the spleen.
Keywords: Pancreatic cyst, spleen-preserving laparoscopic distal pancreatectomy, distal pancreatectomy, laparoscopic pancreatic surgery