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World J Gastroenterol. Oct 14, 2012; 18(38): 5329-5337
Published online Oct 14, 2012. doi: 10.3748/wjg.v18.i38.5329
Laparoscopic distal pancreatectomy: Up-to-date and literature review
Maurizio Iacobone, Marilisa Citton, Donato Nitti
Maurizio Iacobone, Marilisa Citton, Donato Nitti, Minimally Invasive Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35128 Padova, Italy
Author contributions: Iacobone M was responsible for conception and design, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, final approval of the version to be published; Citton M was responsible for conception and design, acquisition, analysis and interpretation of data, drafting the article and revising it, critically for important intellectual content, final approval of the version to be published; Nitti D was responsible for conception and design; analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, final approval of the version to be published.
Correspondence to: Marilisa Citton, MD, Minimally Invasive Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Via Giustiniani 2, 35128 Padova, Italy. marilisa.citton@libero.it
Telephone: +39-4-98211815 Fax: +39-4-98211378
Received: February 24, 2012
Revised: April 19, 2012
Accepted: May 13, 2012
Published online: October 14, 2012
Abstract

Pancreatic surgery represents one of the most challenging areas in digestive surgery. In recent years, an increasing number of laparoscopic pancreatic procedures have been performed and laparoscopic distal pancreatectomy (LDP) has gained world-wide acceptance because it does not require anastomosis or other reconstruction. To date, English literature reports more than 300 papers focusing on LDP, but only 6% included more than 30 patients. Literature review confirms that LDP is a feasible and safe procedure in patients with benign or low grade malignancies. Decreased blood loss and morbidity, early recovery and shorter hospital stay may be the main advantages. Several concerns still exist for laparoscopic pancreatic adenocarcinoma excision. The individual surgeon determines the technical conduction of LDP, with or without spleen preservation; currently robotic pancreatic surgery has gained diffusion. Additional researches are necessary to determine the best technique to improve the procedure results.

Keywords: Pancreas resection, Laparoscopic distal pancreatectomy, Left pancreatectomy, Open pancreatectomy, Pancreatic fistula, Splenectomy, Spleen-preserving technique