Laparoscopic Surgery for Pancreatic Neoplasms

Abstract:

Laparoscopic pancreatic resection has not been widely accepted, because it is regarded as a complicated procedure with a steep learning curve.

However, favorable postoperative results in terms of less pain, less analgesia requirement, early return of bowel function, and shorter hospital stay, in patients who underwent laparoscopic pancreatic resection (Lap PR) for left-sided benign pancreatic lesions have been consistently reported. In addition, in patients with pancreatic tumors localized in the body-tail of the pancreas laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels preservation is feasible and can be achieved in most cases. The reduced incidence of wound infection after Lap DPR is one of the recognized advantages of the laparoscopic approach. Furthermore, another clinical advantage of the Lap DPR is the reduced incidence of a late incisional hernia. Recovery is a very important outcome and can be measured by the patients’ time to return to activities of daily living. However, in oncologic surgery, while these outcomes are important, survival rates are of utmost importance. Laparoscopic en bloc splenopancreatectomy using a modified radical antegrade modular pancretosplenectomy procedure can achieve negative tangential margins in a high percent of patients with resectable malignant tumors of the body and tail of the pancreas.