Completely Laparoscopic Subtotal Pancreatectomy with Splenic Artery Preservation

摘要: Laparoscopic distal pancreatectomy has emerged as an attractive minimally invasive alternative for selected patients. Although technically challenging, with splenic artery preservation consistently been correlated reduced blood loss and perioperative morbidity in multiple studies. Herein presented is our technique completely laparoscopic (non-hand-assisted) subtotal (LSP-SAP). An 87-year-old woman incidentally identified 3-cm cystic lesion the pancreatic body–tail interface underwent EUS, which supported side-branch intraductal papillary mucinous neoplasm. The patient subsequently resection. A procedure was performed using a four-trochar technique. tail body of pancreas were dissected off retroperitoneum along embryologic plane separated from colonic flexure. Next, dissected, isolated, preserved, while vein ventral up to level splenic–portal confluence. employed bipolar cutter-sealing device dissection hemostasis. Pancreatic parenchymal transection standard vascular load endomechanical stapling device. Total time 210 min, estimated 200 mL. Postoperatively, admitted, advanced regular diet next day, discharged home on postoperative day 3. pathological review specimen revealed high-grade dysplasia non-invasive malignant component, classified carcinoma. Foci PanIN 1–3 no high grade at surgical margin. Five lymph nodes included negative malignancy. Completely LSP-SAP can be safely This may optimal open surgery.