Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors

Background: Laparoscopic distal pancreatectomy combined with spleen salvage by preservation of the splenic vessels has been described in selected pati ents with islet cell tumor Methods: Laparoscopic resection of the left side of the pancreas with splee n preservation on the vasa brevia was attempted in six consecutive patients . Results: Four distal pancreatectomies with spleen preservation were complet ed laparoscopically. There were two conversions to laparotomy. The median o perating time was 300 min (range, 240-360). There was no mortality, but two patients developed st pancreatic fistula. The median postoperative hospita l stay was 34.5 days (range, 5-60). All the patients remain well at a media n follow-up of 30 months (range, 22-41). Conclusions: Minimally invasive surgery for distal pancreatic tumors is fea sible and appropriate for most benign tumors. The spleen can be safely pres erved laparoscopically on its blood supply from the short gastric vessels. The operative technique and especially the closure of the pancreatic stump need further study.