Laparoscopic central pancreatectomy: Single institution experience of 6 patients

Background. Medial pancreatectomy is an alternative technique for benign or low-grade malignant tumors of the neck of the Pancreas. We describe our experience of laparoscopic central pancreatectomy. Methods. We conducted a prospective evaluation of laparoscopic pancreatic resection in the Department of Abdominal Surgery at Haut-Leveque Hospital, CHU Bordeaux. From January 1999 until February 2006, 397 patients underwent pancreatic resection for pancreatic lesions, of whom 60 (15%) were enrolled for laparoscopic pancreatic resection. Of the 60 patients, 6 underwent laparoscopic central pancreatectomy. Surgical procedure, postoperative course, and follow-up data were collected. Results. Laparoscopic central pancreatectomy was successful in all patients. In 1 case, we had to perform a laparotomy to find the specimen, which had been lost in the cavity during the anastomosis. The median operative time was 225 minutes (range, 180 to 365 minutes). None of the patients required blood transfusion in the perioperative Period, and there was no mortality. Symptomatic Pancreatic fistula occurred in 2 patients (33%). None of the patients required reaperation or radiologic drainage. Oral feeding was resumed in a median of 11 days (range, 9 to 21 days).. The median postoperative hospital stay was 18 days (range, 15 to 25 days). At a median follow-up of 15 months (range, 4 to 34 months), all patients were alive without exocrine or endocrine insufficiency. Conclusions. Laparoscopic central pancreatectomy is feasible and safe. Laparoscopic central pancreatectomy may become the standard approach for resection of benign or low-grade malignant tumors of the neck of the Pancreas if performed by highly skilled surgeons.