Pure Laparoscopic Distal Pancreatectomy with En Bloc Celiac Axis Resection

Abstract

Abstract

Background:

Recent technological developments and improved endoscopic procedures have greatly enlarged the applications of laparoscopic pancreatic resection.

Patient and Methods:

A 77-year-old female with invasive ductal cancer of the pancreatic body touching the common hepatic and splenic arteries underwent a pure laparoscopic distal pancreatectomy with en bloc celiac axis resection (DP-CAR). The celiac axis, the celiac plexus and ganglions, the left gastric artery, the Gerota fascia, the left adrenal gland, and the retroperitoneal fat tissues above the left renal vein were removed en bloc.

Results:

The procedure took 245 minutes and there was minimal blood loss. The postoperative course was uneventful and the patient was discharged on the seventh postoperative day. The surgical margins were histologically clear (R0 resection).

Conclusion:

Pure laparoscopic DP-CAR is minimally invasive, safe and feasible, and can achieve R0 resection in selected patients with pancreatic invasive ductal adenocarcinoma.