Laparoscopic total pancreatectomy Case report and literature review

被引:14
作者
Wang, Xin [1 ]
Li, Yongbin [1 ]
Cai, Yunqiang [1 ]
Liu, Xubao [1 ]
Peng, Bing [1 ]
机构
[1] Sichuan Univ, Dept Pancreat Surg, West China Hosp, Chengdu 610041, Peoples R China
关键词
laparoscopic techniques; literature review; total pancreatectomy; PYLORUS-PRESERVING PANCREATICODUODENECTOMY; ROBOTIC TOTAL PANCREATECTOMY; SEVERE CHRONIC-PANCREATITIS; ISLET-CELL TRANSPLANTATION; GASTRIC-EMPTYING DGE; LONG-TERM OUTCOMES; INTRADUCTAL PAPILLARY; DISTAL PANCREATECTOMY; SPLENIC ARTERY; CANCER;
D O I
10.1097/MD.0000000000005869
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien-Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n=2) and pancreatic neuroendocrine tumor (PNET) (n=1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450-540 minutes), the mean estimated blood loss was 266mL (range 100-400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8-24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy.
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页数:6
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