Background: Minimally invasive pancreatic surgery, although known to be feasible and safe, is still
not considered a standard procedure. We report our experience with laparoscopic pancreatic surgery
in a retrospective case series.
Materials and Methods: Fifteen consecutive patients (3 male, 12 female) underwent primarily laparoscopic
pancreatic surgery from February 2000 to June 2005. Histologically confirmed diagnoses
were: neuroendocrine pancreatic tumors (n = 11), adult nesidioblastosis (n = 1), serous cystadenoma
(n = 1), and pseudocysts due to chronic pancreatitis (n = 2).
Results: Enucleation (n = 3) or left pancreatic resection with spleen preservation (n = 6) was performed
laparoscopically in 9 patients. The mean (±standard deviation) operative time was 173 ±
48 minutes (range, 120–250 minutes) and the mean postoperative hospital stay was 5.5 ± 1.2 days
(range, 5–8 days) for the laparoscopic cases. Conversion to open surgery was necessary in 6 patients
because of: closeness of the lesion to the portal/mesenteric vein (n = 3), inadequate intraoperative
tumor localization (n = 2), or stapler device dysfunction (n = 1). In these patients, open enucleation
(n = 1), middle segment pancreatectomy (n = 2), left pancreatic resection (n = 2), and pylorus-preserving
Whipple resection (n = 1) were performed. The mean operative time was 268 ± 74 minutes
(range, 150–360 minutes) with a mean postoperative hospital stay of 8 ± 2 days (range, 6–10 days).
Both operative time and hospital stay were significantly longer in patients with secondary open
surgery compared to patients with successful laparoscopic operations.
Conclusion: Laparoscopic enucleation or distal pancreatectomy with spleen preservation for benign
lesions located in the body or tail of the pancreas can be performed safely, with all the potential benefits
of minimally invasive surgery. Preoperative tumor localization is of utmost importance to limit
pancreatic mobilization and to avoid blind pancreatic resection and conversion to open surgery.
