Spleen- preserving laparoscopic distal pancreatectomy: a report of 12 cases from a single institution

Objective To investigate the safety, feasibility, and operation skills of spleen- preserving laparoscopic distal pancreatectomy ( SPLDP) in the treatment of tumors in the body and tail of the pancreas. Methods A retrospective analysis was performed on the medical records of 12 patients who underwent SPLDP at Fujian Provincial Hospital from October 2008 to December 2012; 11 cases had the spleen preserved by Kimura method, and the other one had the spleen preserved by Warshaw method. Results All patients successfully underwent SPLDP without conversion to laparotomy. The mean operative time was 172. 5 min ( 120- 240 min) ; the mean intraoperative blood loss was 191. 7 ml ( 50- 400 ml) ; the mean postoperative length of hospital stay was 9. 5 days ( 4- 25 days) . Three patients had grade B pancreatic fistula after operation and were cured after adequate drainage. After operation, solid pseudopapillary tumor of the pancreas was pathologically confirmed in 4 cases, pancreatic neuroendocrine carcinoma in 2 cases, pancreatic islet cell tumor in 2 cases, pancreatic pseudocyst in 2 cases, and pancreatic cystadenoma in 2 cases. The duration of postoperative follow- up was 6- 51 months, and no diabetes and tumor recurrence were detected. Conclusion SPLDP is safe and feasible in the treatment of benign and low- grade malignant tumors in the body and tail of the pancreas.