Laparoscopic distal pancreatectomy with Division of the pancreatic neck for benign and borderline malignant tumor in the proximal body of the pancreas

Chang Moo Kang, Sung Hoon Choi, Ho Kyoung Hwang, Dong Hyun Kim, Chang Ik Yoon, Woo Jung Lee

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Conventional laparoscopic distal pancreatectomy (DP) is now regarded as a safe, effective treatment modality; however, pancreatic transections are mostly believed to be some where between the body and tail of the pancreas. Laparoscopic DP, with its division at the pancreatic neck (subtotal pancreatectomy [STP]), is more challenging because there are major vascular structures, such as the celiac axis, coronary vein, and superior mesenteric vein-splenic vein-portal vein (SMV-SV-PV) confluence around the pancreatic neck portion to be dissected. Patients and Methods: Ten patients underwent laparoscopic STP with pancreatic division at the level of SMVSV-PV confluence for benign and borderline pancreatic disease. Results: Three patients were male and 7 were female, with a median age of 60 years (range, 28-73). All patients had benign or borderline malignant tumors in the body near the neck of the pancreas, with a median tumor size of 3 cm (range, 1-9.2). The operation time was a median of 287.5 minutes (range, 160-480). The intraopeative bleeding was a median of 300mL (range, 100-700). Spleen preservation was carried out in 8 patients. Compared with open DP with the division of the pancreatic neck, a more frequent rate of spleen preservation (P=0.004), longer operation time (P=0.006), and early postoperative recovery presented by early intake of a soft diet (P=0.001) and earlier discharge (P=0.03) were significantly more frequent in the laparoscopic STP group. In a comparative study with laparoscopic DP, the longer segment of resected pancreas (P<0.001), smaller amount of blood loss (P=0.019), and high rate of spleen preservation (P=0.019) were also noted in the laparoscopic STP group. Conclusions: Laparoscopic DP with division of the pancreatic neck is considered feasible and safe.

Original languageEnglish
Pages (from-to)581-586
Number of pages6
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume20
Issue number7
DOIs
Publication statusPublished - 2010 Sep 1

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Pancreatectomy
Pancreas
Neoplasms
Spleen
Splenic Vein
Mesenteric Veins
Pancreatic Diseases
Portal Vein
Abdomen
Blood Vessels
Coronary Vessels
Hemorrhage
Diet

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Laparoscopic distal pancreatectomy with Division of the pancreatic neck for benign and borderline malignant tumor in the proximal body of the pancreas",
abstract = "Conventional laparoscopic distal pancreatectomy (DP) is now regarded as a safe, effective treatment modality; however, pancreatic transections are mostly believed to be some where between the body and tail of the pancreas. Laparoscopic DP, with its division at the pancreatic neck (subtotal pancreatectomy [STP]), is more challenging because there are major vascular structures, such as the celiac axis, coronary vein, and superior mesenteric vein-splenic vein-portal vein (SMV-SV-PV) confluence around the pancreatic neck portion to be dissected. Patients and Methods: Ten patients underwent laparoscopic STP with pancreatic division at the level of SMVSV-PV confluence for benign and borderline pancreatic disease. Results: Three patients were male and 7 were female, with a median age of 60 years (range, 28-73). All patients had benign or borderline malignant tumors in the body near the neck of the pancreas, with a median tumor size of 3 cm (range, 1-9.2). The operation time was a median of 287.5 minutes (range, 160-480). The intraopeative bleeding was a median of 300mL (range, 100-700). Spleen preservation was carried out in 8 patients. Compared with open DP with the division of the pancreatic neck, a more frequent rate of spleen preservation (P=0.004), longer operation time (P=0.006), and early postoperative recovery presented by early intake of a soft diet (P=0.001) and earlier discharge (P=0.03) were significantly more frequent in the laparoscopic STP group. In a comparative study with laparoscopic DP, the longer segment of resected pancreas (P<0.001), smaller amount of blood loss (P=0.019), and high rate of spleen preservation (P=0.019) were also noted in the laparoscopic STP group. Conclusions: Laparoscopic DP with division of the pancreatic neck is considered feasible and safe.",
author = "Kang, {Chang Moo} and Choi, {Sung Hoon} and Hwang, {Ho Kyoung} and Kim, {Dong Hyun} and Yoon, {Chang Ik} and Lee, {Woo Jung}",
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Laparoscopic distal pancreatectomy with Division of the pancreatic neck for benign and borderline malignant tumor in the proximal body of the pancreas. / Kang, Chang Moo; Choi, Sung Hoon; Hwang, Ho Kyoung; Kim, Dong Hyun; Yoon, Chang Ik; Lee, Woo Jung.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 20, No. 7, 01.09.2010, p. 581-586.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Laparoscopic distal pancreatectomy with Division of the pancreatic neck for benign and borderline malignant tumor in the proximal body of the pancreas

AU - Kang, Chang Moo

AU - Choi, Sung Hoon

AU - Hwang, Ho Kyoung

AU - Kim, Dong Hyun

AU - Yoon, Chang Ik

AU - Lee, Woo Jung

PY - 2010/9/1

Y1 - 2010/9/1

N2 - Conventional laparoscopic distal pancreatectomy (DP) is now regarded as a safe, effective treatment modality; however, pancreatic transections are mostly believed to be some where between the body and tail of the pancreas. Laparoscopic DP, with its division at the pancreatic neck (subtotal pancreatectomy [STP]), is more challenging because there are major vascular structures, such as the celiac axis, coronary vein, and superior mesenteric vein-splenic vein-portal vein (SMV-SV-PV) confluence around the pancreatic neck portion to be dissected. Patients and Methods: Ten patients underwent laparoscopic STP with pancreatic division at the level of SMVSV-PV confluence for benign and borderline pancreatic disease. Results: Three patients were male and 7 were female, with a median age of 60 years (range, 28-73). All patients had benign or borderline malignant tumors in the body near the neck of the pancreas, with a median tumor size of 3 cm (range, 1-9.2). The operation time was a median of 287.5 minutes (range, 160-480). The intraopeative bleeding was a median of 300mL (range, 100-700). Spleen preservation was carried out in 8 patients. Compared with open DP with the division of the pancreatic neck, a more frequent rate of spleen preservation (P=0.004), longer operation time (P=0.006), and early postoperative recovery presented by early intake of a soft diet (P=0.001) and earlier discharge (P=0.03) were significantly more frequent in the laparoscopic STP group. In a comparative study with laparoscopic DP, the longer segment of resected pancreas (P<0.001), smaller amount of blood loss (P=0.019), and high rate of spleen preservation (P=0.019) were also noted in the laparoscopic STP group. Conclusions: Laparoscopic DP with division of the pancreatic neck is considered feasible and safe.

AB - Conventional laparoscopic distal pancreatectomy (DP) is now regarded as a safe, effective treatment modality; however, pancreatic transections are mostly believed to be some where between the body and tail of the pancreas. Laparoscopic DP, with its division at the pancreatic neck (subtotal pancreatectomy [STP]), is more challenging because there are major vascular structures, such as the celiac axis, coronary vein, and superior mesenteric vein-splenic vein-portal vein (SMV-SV-PV) confluence around the pancreatic neck portion to be dissected. Patients and Methods: Ten patients underwent laparoscopic STP with pancreatic division at the level of SMVSV-PV confluence for benign and borderline pancreatic disease. Results: Three patients were male and 7 were female, with a median age of 60 years (range, 28-73). All patients had benign or borderline malignant tumors in the body near the neck of the pancreas, with a median tumor size of 3 cm (range, 1-9.2). The operation time was a median of 287.5 minutes (range, 160-480). The intraopeative bleeding was a median of 300mL (range, 100-700). Spleen preservation was carried out in 8 patients. Compared with open DP with the division of the pancreatic neck, a more frequent rate of spleen preservation (P=0.004), longer operation time (P=0.006), and early postoperative recovery presented by early intake of a soft diet (P=0.001) and earlier discharge (P=0.03) were significantly more frequent in the laparoscopic STP group. In a comparative study with laparoscopic DP, the longer segment of resected pancreas (P<0.001), smaller amount of blood loss (P=0.019), and high rate of spleen preservation (P=0.019) were also noted in the laparoscopic STP group. Conclusions: Laparoscopic DP with division of the pancreatic neck is considered feasible and safe.

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